Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Relationship Between Sluggish Cognitive Tempo and Age and IQ in Preschool and School-Age Children and Adolescents with Autism and with ADHD

Journal of Autism and Developmental Disorders - Relationships between sluggish cognitive tempo (SCT) and age and IQ were investigated in children with autism and/or ADHD covering broader age and IQ...     

Synaptic plasticity and learning and memory: LTP and beyond.

Long-term potentiation (LTP) of synaptic activity is by far the most popular and widely researched model of synaptic plastic changes that might occur during learning. Numerous recent reports, however, have not found a correlation between the inducibility of LTP in the hippocampus and the ability of animals to learn hippocampus-dependent tasks. For example, some experiments with gene deletion (knockout) mice strains have shown that in some strains LTP is not inducible in the dentate gyrus, in area CA3, or CA1, but the animals are still able to learn spatial tasks. This apparent mismatch has rejuvenated the discussion concerning whether LTP is a good model for mechanisms that underlie memory formation in the nervous system. This review analyzes the conditions under which LTP is induced or learning takes place and suggests reasons for the mismatches that can occur and what we can learn from them. High-frequency stimulation protocols and in vitro assays cannot be seen to resemble natural firing patterns or conditions found in the brain. More physiological experimental conditions, especially in vivo recording in awake animals, could lead the way to the development of improved models of learning mechanisms that better correlate with learning abilities of animals.     

Musical and poetic creativity and epilepsy

Associations between epilepsy and musical or poetic composition have received little attention. We reviewed the literature on links between poetic and musical skills and epilepsy, limiting this to the Western canon. While several composers were said to have had epilepsy, John Hughes concluded that none of the major classical composers thought to have had epilepsy actually had it. The only composer with epilepsy that we could find was the contemporary composer, Hikari Oe, who has autism and developed epilepsy at age 15 years. In his childhood years, his mother found that he had an ability to identify bird sound and keys of songs and began teaching him piano. Hikari is able to compose in his head when his seizures are not severe, but when his seizures worsen, his creativity is lost. Music critics have commented on the simplicity of his musical composition and its monotonous sound.Our failure to find evidence of musical composers with epilepsy finds parallels with poetry where there are virtually no established poets with epilepsy. Those with seizures include Lord George Byron in the setting of terminal illness, Algernon Swinburne who had alcohol-related seizures, Charles Lloyd who had seizures and psychosis, Edward Lear who had childhood onset seizures, and Vachel Lindsay. The possibility that Emily Dickinson had epilepsy is also discussed.It has not been possible to identify great talents with epilepsy who excel in poetic or musical composition. There are few published poets with epilepsy and no great composers. Why is this? Similarities between music and poetry include meter, tone, stress, rhythm, and form, and much poetry is sung with music. It is likely that great musical and poetic compositions demand a greater degree of concentration and memory than is possible in epilepsy, resulting in problems retaining a musical and mathematical structure over time. The lack of association between recognizable neuropsychiatric disorders and these skills is a gateway to understanding facets of the relationship between the brain and creativity.This article is part of a Special Issue entitled “Epilepsy, Art, and Creativity”.     

Serious emotional and behavioral problems and mental health contacts in American and British children and adolescents

OBJECTIVE: To compare prevalence of serious emotional and behavioral problems and mental health contacts for these problems among American and British children and adolescents. METHOD: Data on children and adolescents ages 5 to 16 years were drawn from the 2004 U.S. National Health Interview Survey (response rate = 79.4%) and the 2004 survey of Mental Health of Children and Young People in Great Britain (response rate = 76.0%). Emotional problems, hyperactivity/inattention, and conduct problems were assessed using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Psychometric properties of SDQ scales were compared across countries. RESULTS: The SDQ has similar psychometric properties across countries. More British than American children met the criteria for emotional and conduct problems, but not hyperactivity/inattention. Prevalence was higher for all problems in 5- to 8-year-old British boys and for emotional problems in 13- to 16-year-old British girls. American children with serious emotional and behavioral problems had a higher prevalence of mental health contacts overall and with mental health providers but not with general medical providers. CONCLUSIONS: British children have a higher prevalence of parent-reported serious emotional and behavioral problems than American children. However, British children with these problems are less likely than American children to receive mental health care.     

Spatial attention and conscious perception: interactions and dissociations between and within endogenous and exogenous processes

A current controversy exists about the relationship between spatial attention and conscious perception. While some authors propose that these phenomena are intimately related (Bartolomeo, 2008, Chun and Marois, 2002, O’Regan and Noë, 2001, Posner, 1994), others report dissociations between them (Kentridge et al., 1999, Koch and Tsuchiya, 2007, Wyart and Tallon-Baudry, 2008). However, spatial attention is not a unitary mechanism, and it is possible that not all forms of attention dissociate from conscious perception. In the present study we used a paradigm in which endogenous and exogenous forms of attention are orthogonally manipulated in order to investigate their relation with conscious perception within the same design. By analyzing two different cue-related components, our results demonstrated that while endogenous attention was electrophysiologically dissociated from conscious perception, exogenous attention was not, consistent with the hypothesis that exogenous attention is an important antecedent of our conscious experience. Our results support previous claims of dissociations between some forms of spatial attention and conscious perception, but also highlight the importance of exogenous orienting on the selection of information for conscious access.     

Anger and depression--theoretical and clinical considerations

The Freudian idea of inhibited anger being central to the pathogenesis of depression has been one of the cornerstones of psychiatric thinking. The aim of this article is to review the literature on psychotherapy theory and the relevant research with regard to the association of anger and depression, and to discuss clinical implications in treating depressive patients. Choice of research articles was based on systematic search of databases. Psychotherapy theories are mostly found in books not included in databases. Literature on psychotherapy theory was selectively chosen. Over-control, under-control and mixtures of the two may be present in depression, indicating problems in anger regulation. The links between anger and depression form a complex network. When treating patients with depression, explicit or implicit dealing with anger often seems to be helpful. In clinical reality, the relative amounts of elicitation of anger experience and training in expressive control needed by depressive patients may vary between different types of patients, different phases of depressive disorder, and different phases of therapy.     

Retrospective and prospective design and data

The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder - MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile.     

Zonisamide and associated oligohidrosis and hyperthermia

Zonisamide is an antiepileptic agent that is indicated as adjunctive therapy for the treatment of partial seizures in adults. Oligohidrosis has been reported in a small number of patients receiving zonisamide and, in a proportion of these patients, hyperthermia has occurred. Most reports of hyperthermia have been in children, typically occurring during the summer months. However, the mechanism of zonisamide-associated oligohidrosis is not fully understood. Thirteen events of oligohidrosis, or hyperthermia, associated with zonisamide were reported in the US during the 3 years after zonisamide was approved, an estimated incidence of 1 case per 4590 patient-years. These events happened mostly in children. In Japan, all reported cases of zonisamide-associated oligohidrosis or hyperthermia have been in children, with an incidence of 1 case per 10,000 pediatric-years during the first 11 years of marketing. In each case, oligohidrosis was reversible upon discontinuation of zonisamide. Ensuring that children remain cool and well hydrated during hot weather can minimize the potential for hyperthermia resulting from oligohidrosis.     

Antidepressants and cytokines--clinical and experimental studies

Clinical and experimental studies indicate that stress and depression are associated with the up-regulation of the immune system, including increased production of pro-inflammatory cytokines. When administered to patients or laboratory animals, some of these cytokines induce typical symptoms of depression. It is known that cytokines modulate brain neurotransmission and the activity of the hypothalamic-pituitary-adrenal axis, both of which are disturbed in depression. This review summarizes in vivo, ex vivo and in vitro clinical and experimental studies of the effect of antidepressants on cytokine production. In vitro culture and animal studies in particular suggest that antidepressants of several classes decrease the production of pro-inflammatory cytokines and shift the pro/anti-inflammatory cytokine balance towards the latter. Some studies suggest that immunological disturbances, including changes in cytokine levels, are not shared by all depressive patients, which means that only in certain groups of patients may the immunomodulatory action of antidepressants play a significant role in producing the therapeutic effect.