WorldWideScience

Sample records for disorders preliminary insights

  1. Insight in seasonal affective disorder.

    Science.gov (United States)

    Ghaemi, S N; Sachs, G S; Baldassano, C F; Truman, C J

    1997-01-01

    Lack of insight complicates the evaluation and treatment of patients with psychotic and affective disorders. No studies of insight in seasonal affective disorder (SAD) have been reported. Thirty patients with SAD diagnosed by the Structured Clinical Interview for DSM-III-R but no other axis I conditions were treated short-term with light-therapy. Insight was measured with the Scale to Assess Unawareness of Mental Disorder (SUMD) as modified by the authors to assess the self-report of insight into depressive symptoms. Increasing scores (1 to 5) indicated increasing unawareness of illness (i.e., less insight). SAD patients displayed a moderate amount of insight when depressed (mean SUMD score, 2.5). When recovered, they showed no significant change in insight into past depressive symptoms (mean SUMD score, 2.8). Greater insight into current depressive symptoms correlated with more depressive symptoms on the Hamilton Rating Scale for Depression score ([HRSD] r = .35, P depressive symptoms that does not change after recovery, a result in agreement with studies of insight in psychosis and mania. Further, in SAD, increased severity of illness may be associated with increased insight into depressive symptoms, consistent with the hypothesis of depressive realism.

  2. Avoidant personality disorder: current insights

    OpenAIRE

    Lampe,Lisa; Malhi,Gin

    2018-01-01

    Lisa Lampe,1 Gin S Malhi2 1Discipline of Psychiatry, University of Newcastle, Newcastle, NSW, Australia; 2Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia Abstract: Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective t...

  3. Avoidant personality disorder: current insights

    Directory of Open Access Journals (Sweden)

    Lampe L

    2018-03-01

    Full Text Available Lisa Lampe,1 Gin S Malhi2 1Discipline of Psychiatry, University of Newcastle, Newcastle, NSW, Australia; 2Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia Abstract: Avoidant personality disorder (AVPD is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD, schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the “severity continuum hypothesis”, in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment. Keywords: avoidant personality disorder, social anxiety disorder, social cognition, psychotherapy, attachment

  4. Avoidant personality disorder: current insights.

    Science.gov (United States)

    Lampe, Lisa; Malhi, Gin S

    2018-01-01

    Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the "severity continuum hypothesis", in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment.

  5. Avoidant personality disorder: current insights

    Science.gov (United States)

    Lampe, Lisa; Malhi, Gin S

    2018-01-01

    Avoidant personality disorder (AVPD) is a relatively common disorder that is associated with significant distress, impairment, and disability. It is a chronic disorder with an early age at onset and a lifelong impact. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment. The impetus for research into this condition has waxed and waned, possibly due to concerns regarding its distinctiveness from other disorders, especially social anxiety disorder (SAD), schizoid personality disorder, and dependent personality disorder. The prevailing paradigm subscribes to the “severity continuum hypothesis”, in which AVPD is viewed essentially as a severe variant of SAD. However, areas of discontinuity have been described, and there is support for retaining AVPD as a distinct diagnostic category. Recent research has focused on the phenomenology of AVPD, factors of possible etiological significance such as early parenting experiences, attachment style, temperament, and cognitive processing. Self-concept, avoidant behavior, early attachments, and attachment style may represent points of difference from SAD that also have relevance to treatment. Additional areas of research not focused specifically on AVPD, including the literature on social cognition as it relates to attachment and personality style, report findings that are promising for future research aimed at better delineating AVPD and informing treatment. PMID:29563846

  6. Oppositional defiant disorder: current insight

    Directory of Open Access Journals (Sweden)

    Ghosh A

    2017-11-01

    Full Text Available Abhishek Ghosh,1 Anirban Ray,2 Aniruddha Basu1 1Drug De-addiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER, Chandigarh, 2Department of Psychiatry, Institute of Psychiatry, Institute of Post Graduate Medical Education and Research, Kolkata, India Abstract: Oppositional defiant disorder (ODD is diagnosed broadly on the basis of frequent and persistent angry or irritable mood, argumentativeness/defiance, and vindictiveness. Since its inception in the third Diagnostic and Statistical Manual of Mental Disorders, epidemiological and longitudinal studies have strongly suggested a distinct existence of ODD that is different from other closely related externalizing disorders, with different course and outcome and possibly discrete subtypes. However, several issues, such as symptom threshold, dimensional versus categorical conceptualization, and sex-specific symptoms, are yet to be addressed. Although ODD was found to be highly heritable, no genetic polymorphism has been identified with confidence. There has been a definite genetic overlap with other externalizing disorders. Studies have begun to explore its epigenetics and gene–environment interaction. Neuroimaging findings converge to implicate various parts of the prefrontal cortex, amygdala, and insula. Alteration in cortisol levels has also been demonstrated consistently. Although a range of environmental factors, both familial and extrafamilial, have been studied in the past, current research has combined these with other biological parameters. Psychosocial treatment continues to be time-tested and effective. These include parental management training, school-based training, functional family therapy/brief strategic family therapy, and cognitive behavior therapy. Management of severe aggression and treatment of co-morbid disorders are indications for pharmacotherapy. In line with previous conceptualization of chronic

  7. Laryngeal electromyography in movement disorders: preliminary data

    Directory of Open Access Journals (Sweden)

    Kimaid Paulo A.T.

    2004-01-01

    Full Text Available This study describes preliminary laryngeal electromyography (LEMG data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD, 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS. LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

  8. Uncovering the etiology of conversion disorder: insights from functional neuroimaging

    Science.gov (United States)

    Ejareh dar, Maryam; Kanaan, Richard AA

    2016-01-01

    Conversion disorder (CD) is a syndrome of neurological symptoms arising without organic cause, arguably in response to emotional stress, but the exact neural substrates of these symptoms and the underlying mechanisms remain poorly understood with the hunt for a biological basis afoot for centuries. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from CDs in both motor and nonmotor domains. This review summarizes recent functional neuroimaging studies including functional magnetic resonance imaging (fMRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET) to see whether they bring us closer to understanding the etiology of CD. Convergent functional neuroimaging findings suggest alterations in brain circuits that could point to different mechanisms for manifesting functional neurological symptoms, in contrast with feigning or healthy controls. Abnormalities in emotion processing and in emotion-motor processing suggest a diathesis, while differential reactions to certain stressors implicate a specific response to trauma. No comprehensive theory emerges from these clues, and all results remain preliminary, but functional neuroimaging has at least given grounds for hope that a model for CD may soon be found. PMID:26834476

  9. A Preliminary Classification of Human Functional Sexual Disorders

    Science.gov (United States)

    Sharpe, Lawrence; And Others

    1976-01-01

    A preliminary classification is presented for functional human sexual disorders. This system is based on objective behavior and reports of distress. Five categories of sexual disorders are proposed, including the behavioral, psychological and informational components of sexual functioning in the individual and the couple. (Author)

  10. Impaired insight into illness and cognitive insight in schizophrenia spectrum disorders: Resting state functional connectivity

    Science.gov (United States)

    Gerretsen, Philip; Menon, Mahesh; Mamo, David C.; Fervaha, Gagan; Remington, Gary; Pollock, Bruce G.; Graff-Guerrero, Ariel

    2015-01-01

    Background Impaired insight into illness (clinical insight) in schizophrenia has negative effects on treatment adherence and clinical outcomes. Schizophrenia is described as a disorder of disrupted brain connectivity. In line with this concept, resting state networks (RSNs) appear differentially affected in persons with schizophrenia. Therefore, impaired clinical, or the related construct of cognitive insight (which posits that impaired clinical insight is a function of metacognitive deficits), may reflect alterations in RSN functional connectivity (fc). Based on our previous research, which showed that impaired insight into illness was associated with increased left hemisphere volume relative to right, we hypothesized that impaired clinical insight would be associated with increased connectivity in the DMN with specific left hemisphere brain regions. Methods Resting state MRI scans were acquired for participants with schizophrenia or schizoaffective disorder (n = 20). Seed-to-voxel and ROI-to-ROI fc analyses were performed using the CONN-fMRI fc toolbox v13 for established RSNs. Clinical and cognitive insight were measured with the Schedule for the Assessment of Insight—Expanded Version and Beck Cognitive Insight Scale, respectively, and included as the regressors in fc analyses. Results As hypothesized, impaired clinical insight was associated with increased connectivity in the default mode network (DMN) with the left angular gyrus, and also in the self-referential network (SRN) with the left insula. Cognitive insight was associated with increased connectivity in the dorsal attention network (DAN) with the right inferior frontal cortex (IFC) and left anterior cingulate cortex (ACC). Conclusion Increased connectivity in DMN and SRN with the left angular gyrus and insula, respectively, may represent neural correlates of impaired clinical insight in schizophrenia spectrum disorders, and is consistent with the literature attributing impaired insight to left

  11. A study of poor insight in social anxiety disorder.

    Science.gov (United States)

    Vigne, Paula; de Menezes, Gabriela B; Harrison, Ben J; Fontenelle, Leonardo F

    2014-11-30

    We investigated levels of insight among patients with Social Anxiety Disorder (SAD) as compared to patients with Obsessive-Compulsive Disorder (OCD) and evaluated whether levels of insight in SAD were related to specific sociodemographic and/or clinical features. Thirty-seven SAD patients and 51 OCD patients attending a tertiary obsessive-compulsive and anxiety disorders clinic were assessed with a sociodemographic and clinical questionnaire, a structured diagnostic interview, the Brown Assessment of Beliefs Scale (BABS), the Social Phobia Inventory (SPIN), the Beck Depression Inventory (BDI), the Sheehan Disability Scale (SDS), and the Treatment Adherence Survey-patient version (TAS-P). According to the BABS, SAD patients exhibited insight levels that were as low as those exhibited by OCD patients, with up to 29.7% of them being described as "poor insight" SAD. Although poor insight SAD patients were more frequently married, less depressed and displayed a statistical trend towards greater rates of early drop-out from cognitive-behavioral therapy, their insight levels were not associated with other variables of interest, including sex, age, employment, age at onset, duration of illness, associated psychiatric disorders, SPIN and SDS scores. Patients with poor insight SAD might perceive their symptoms as being less distressful and thus report fewer depressive symptoms and high rates of treatment non-adherence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Disruptive mood dysregulation disorder: current insights

    Directory of Open Access Journals (Sweden)

    Baweja R

    2016-08-01

    Full Text Available Raman Baweja, Susan D Mayes, Usman Hameed, James G Waxmonsky Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, USA Abstract: Disruptive mood dysregulation disorder (DMDD was introduced as a new diagnostic entity under the category of depressive disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5. It was included in DSM-5 primarily to address concerns about the misdiagnosis and consequent overtreatment of bipolar disorder in children and adolescents. DMDD does provide a home for a large percentage of referred children with severe persistent irritability that did not fit well into any DSM, Fourth Edition (DSM-IV diagnostic category. However, it has been a controversial addition to the DSM-5 due to lack of published validity studies, leading to questions about its validity as a distinct disorder. In this article, the authors discuss the diagnostic criteria, assessment, epidemiology, criticism of the diagnosis, and pathophysiology, as well as treatment and future directions for DMDD. They also review the literature on severe mood dysregulation, as described by the National Institute of Mental Health, as the scientific support for DMDD is based primarily on studies of severe mood dysregulation. Keywords: disruptive mood dysregulation disorder, persistent irritability, temper outbursts 

  13. Insight, Cognitive Insight and Sociodemographic Features in Obsessive Compulsive Disorder Presenting with Reactive and Autogeneus Features

    Directory of Open Access Journals (Sweden)

    Katre ÇAMLI

    2012-03-01

    Full Text Available Objective: The aim of the present study was to test hypothesis that obsessive compulsive disorder (OCD patients who have autogenous obsessions and reactive obsessions show different sociodemographic and clinical characteristics with different insight and cognitive insight levels. Method: Sixty-one patients diagnosed as OCD according to the Structured Clinical Interview for DSM-III-R (SCID-I are recruited. 31 patients had reactive obsessions and 30 had autogenous obsessions. The sociodemographic characteristics of patients and the symptomatology were evaluated using psychiatric scales including SCID-I, Yale Brown Obsessive- Compulsive Scale (YBOCS, Yale Brown Obsessive-Compulsive Scale-Symptom Checklist (YBOCS-SC and Beck Insight Scale. Results: The percentage of women in reactive obsessive group was higher and also this group had significantly less antipsychotic medication prescribed than the autogenous obsessive group. No significant difference was found for the other demographic variables. No significant difference was identified for the Beck Insight Self-Reflectiveness subscale but for the Self-Certainty subscale, reactive obsessives had higher scores. Although there was no significant difference for the composit index points, which is the subtraction of the two subscales, the p value was close to the limit. On the other hand YBOCS item- 11 scores which evaluates insight were higher in autogenous obsessives meaning low levels of insight. Conclusion: For the sociodemographic and clinical characteristics; there was no significant difference between the groups except gender distribution and antipsychotic medication. Our data about insight seems inconsistent but insight and cognitive insight can be different entities which show different levels of insight. Further investigation with different obsession types is needed.

  14. Insight in bipolar disorder : associations with cognitive and emotional processing and illness characteristics

    NARCIS (Netherlands)

    van der Werf - Eldering, Marieke; van der Meer, Lisette; Burger, Huibert; Holthausen, Esther; Nolen, W.A.; Aleman, Andre

    Objective: To investigate the multifactorial relationship between illness insight, cognitive and emotional processes, and illness characteristics in bipolar disorder patients. Methods: Data from 85 euthymic or mildly to moderately depressed bipolar disorder patients were evaluated. Insight was

  15. Possession experiences in dissociative identity disorder: a preliminary study.

    Science.gov (United States)

    Ross, Colin A

    2011-01-01

    Dissociative trance disorder, which includes possession experiences, was introduced as a provisional diagnosis requiring further study in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Consideration is now being given to including possession experiences within dissociative identity disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), which is due to be published in 2013. In order to provide empirical data relevant to the relationship between DID and possession states, I analyzed data on the prevalence of trance, possession states, sleepwalking, and paranormal experiences in 3 large samples: patients with DID from North America; psychiatric outpatients from Shanghai, China; and a general population sample from Winnipeg, Canada. Trance, sleepwalking, paranormal, and possession experiences were much more common in the DID patients than in the 2 comparison samples. The study is preliminary and exploratory in nature because the samples were not matched in any way.

  16. Genetic Aspects of Autism Spectrum Disorders: Insights from Animal Models

    Directory of Open Access Journals (Sweden)

    Swati eBanerjee

    2014-02-01

    Full Text Available Autism spectrum disorders (ASD are a complex neurodevelopmental disorder that display a triad of core behavioral deficits including restricted interests, often accompanied by repetitive behavior, deficits in language and communication, and an inability to engage in reciprocal social interactions. ASD is among the most heritable disorders but is not a simple disorder with a singular pathology and has a rather complex etiology. It is interesting to note that perturbations in synaptic growth, development and stability underlie a variety of neuropsychiatric disorders, including ASD, schizophrenia, epilepsy and intellectual disability. Biological characterization of an increasing repertoire of synaptic mutants in various model organisms indicates synaptic dysfunction as causal in the pathophysiology of ASD. Our understanding of the genes and genetic pathways that contribute towards the formation, stabilization and maintenance of functional synapses coupled with an in-depth phenotypic analysis of the cellular and behavioral characteristics is therefore essential to unraveling the pathogenesis of these disorders. In this review, we discuss the genetic aspects of ASD emphasizing on the well conserved set of genes and genetic pathways implicated in this disorder, many of which contribute to synapse assembly and maintenance across species. We also review how fundamental research using animal models is providing key insights into the various facets of human ASD.

  17. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED).

    Science.gov (United States)

    Simpson, Susan G; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B; Castelnuovo, Gianluca

    2018-01-01

    Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.

  18. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED

    Directory of Open Access Journals (Sweden)

    Susan G. Simpson

    2018-04-01

    Full Text Available Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED in a disordered eating population.Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q completed the 190-item adapted version of the Schema Mode Inventory (SMI. The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA and internal consistency (Cronbach's α. Multivariate Analyses of Covariance (MANCOVA was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables.Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population.Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.

  19. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED)

    Science.gov (United States)

    Simpson, Susan G.; Pietrabissa, Giada; Rossi, Alessandro; Seychell, Tahnee; Manzoni, Gian Mauro; Munro, Calum; Nesci, Julian B.; Castelnuovo, Gianluca

    2018-01-01

    Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population. PMID:29740379

  20. Cognitive functioning and insight in schizophrenia and in schizoaffective disorder.

    Science.gov (United States)

    Birindelli, Nadia; Montemagni, Cristiana; Crivelli, Barbara; Bava, Irene; Mancini, Irene; Rocca, Paola

    2014-01-01

    The aim of this study was to investigate cognitive functioning and insight of illness in two groups of patients during their stable phases, one with schizophrenia and one with schizoaffective disorder. We recruited 104 consecutive outpatients, 64 with schizophrenia, 40 with schizoaffective disorder, in the period between July 2010 and July 2011. They all fulfilled formal Diagnostic and Statistical Manual of Mental disorders (DSM-IV-TR) diagnostic criteria for schizophrenia and schizoaffective disorder. Psychiatric assessment included the Clinical Global Impression Scale-Severity (CGI-S), the Positive and Negative Sindrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Global Assessment of Functioning (GAF). Insight of illness was evaluated using SUMD. Neuropsychological assessment included Winsconsin Card Sorting Test (WCST), California Verbal Learning Test (CVLT), Stroop Test and Trail Making Test (TMT). Differences between the groups were tested using Chi-square test for categorical variables and one-way analysis of variance (ANOVA) for continuous variables. All variables significantly different between the two groups of subjects were subsequently analysed using a logistic regression with a backward stepwise procedure using diagnosis (schizophrenia/schizoaffective disorder) as dependent variable. After backward selection of variables, four variables predicted a schizoaffective disorder diagnosis: marital status, a higher number of admission, better attentive functions and awareness of specific signs or symptoms of disease. The prediction model accounted for 55% of the variance of schizoaffective disorder diagnosis. With replication, our findings would allow higher diagnostic accuracy and have an impact on clinical decision making, in light of an amelioration of vocational functioning.

  1. Pathogenesis of the Metabolic Syndrome: Insights from Monogenic Disorders

    Directory of Open Access Journals (Sweden)

    Rinki Murphy

    2013-01-01

    Full Text Available Identifying rare human metabolic disorders that result from a single-gene defect has not only enabled improved diagnostic and clinical management of such patients, but also has resulted in key biological insights into the pathophysiology of the increasingly prevalent metabolic syndrome. Insulin resistance and type 2 diabetes are linked to obesity and driven by excess caloric intake and reduced physical activity. However, key events in the causation of the metabolic syndrome are difficult to disentangle from compensatory effects and epiphenomena. This review provides an overview of three types of human monogenic disorders that result in (1 severe, non-syndromic obesity, (2 pancreatic beta cell forms of early-onset diabetes, and (3 severe insulin resistance. In these patients with single-gene defects causing their exaggerated metabolic disorder, the primary defect is known. The lessons they provide for current understanding of the molecular pathogenesis of the common metabolic syndrome are highlighted.

  2. Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy.

    Science.gov (United States)

    Vohs, Jenifer L; Leonhardt, Bethany L; James, Alison V; Francis, Michael M; Breier, Alan; Mehdiyoun, Nikki; Visco, Andrew C; Lysaker, Paul H

    2018-05-01

    Poor insight impedes treatment in early phase psychosis (EPP). This manuscript outlines preliminary findings of an investigation of the novel metacognitively oriented integrative psychotherapy, Metacognitive Reflection and Insight Therapy, for individuals with early phase psychosis (MERIT-EP). Twenty adults with EPP and poor insight were randomized to either six months of MERIT-EP or treatment as usual (TAU). Therapists were trained and therapy was successfully delivered under routine, outpatient conditions. Insight, assessed before and after treatment, revealed significant improvement for the MERIT-EP, but not TAU, group. These results suggest MERIT-EP is feasible to deliver, accepted by patients, and leads to clinically significant improvements in insight. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Preliminary experimental insights into differential heat impact among lithic artifacts

    Directory of Open Access Journals (Sweden)

    Guillermo Bustos-Pérez

    2016-09-01

    Full Text Available The presence of thermally altered and broken flint artifacts is common at archaeological sites. Most studies focus their attention on the effects of heat treatment on flint to improve knapping qualities, disregarding the effects of fire over flint under uncontrolled conditions. This paper aims to show how under uncontrolled heating processes flint artifacts develop different heat alterations (such as levels of breakage, presence of scales, etc. as a result of vertical distribution, volume or raw material and to establish a gradient of rock changes and behavior. Artifacts where macroscopically analyzed and a series of uncontrolled heating experiments through the distribution of flint blanks under two hearths were carried out, allowing a comparison of the before and after of the blanks. Preliminary results show how levels of breakage, surface alteration or development of heat alteration features can be differentiated according to artifact volume, vertical distribution and level of surface alteration. Results also show how two different raw materials react differently to similar thermal impact, and how surface alteration reacts at different rhythm in the case of recycled artifacts. We conclude that levels of thermal alteration can be differentiated through macroscopic analysis of flint surface.

  4. Genomic and Epigenomic Insights into Nutrition and Brain Disorders

    Directory of Open Access Journals (Sweden)

    Margaret Joy Dauncey

    2013-03-01

    Full Text Available Considerable evidence links many neuropsychiatric, neurodevelopmental and neurodegenerative disorders with multiple complex interactions between genetics and environmental factors such as nutrition. Mental health problems, autism, eating disorders, Alzheimer’s disease, schizophrenia, Parkinson’s disease and brain tumours are related to individual variability in numerous protein-coding and non-coding regions of the genome. However, genotype does not necessarily determine neurological phenotype because the epigenome modulates gene expression in response to endogenous and exogenous regulators, throughout the life-cycle. Studies using both genome-wide analysis of multiple genes and comprehensive analysis of specific genes are providing new insights into genetic and epigenetic mechanisms underlying nutrition and neuroscience. This review provides a critical evaluation of the following related areas: (1 recent advances in genomic and epigenomic technologies, and their relevance to brain disorders; (2 the emerging role of non-coding RNAs as key regulators of transcription, epigenetic processes and gene silencing; (3 novel approaches to nutrition, epigenetics and neuroscience; (4 gene-environment interactions, especially in the serotonergic system, as a paradigm of the multiple signalling pathways affected in neuropsychiatric and neurological disorders. Current and future advances in these four areas should contribute significantly to the prevention, amelioration and treatment of multiple devastating brain disorders.

  5. Genomic Insights into Growth and Its Disorders: An Update

    Science.gov (United States)

    de Bruin, Christiaan; Dauber, Andrew

    2016-01-01

    Purpose of review To provide an update of the most striking new developments in the field of growth genetics over the past 12 months Recent findings A number of large genome-wide association studies have identified new genetic loci and pathways associated to human growth and adult height as well as related traits and comorbidities. New genetic etiologies of primordial dwarfism and several short stature syndromes have been elucidated. Moreover, a breakthrough finding of Xq26 microduplications as a cause of pituitary gigantism was made. Several new developments in imprinted growth-related genes (including the first human mutation in IGF-II) and novel insights into the epigenetic regulation of growth have been reported. Summary Genomic investigations continue to provide new insights into the genetic basis of human growth as well as its disorders. PMID:26702851

  6. Formal thought disorder, neuropsychology and insight in schizophrenia.

    Science.gov (United States)

    Barrera, Alvaro; McKenna, Peter J; Berrios, German E

    2009-01-01

    Information provided by patients with schizophrenia and their respective carers is used to study the descriptive psychopathology and neuropsychology of formal thought disorder (FTD). Relatively intellectually preserved schizophrenia patients (n = 31) exhibiting from no to severe positive FTD completed a self-report scale of FTD, a scale of insight as well as several tests of executive and semantic function. The patients' carers completed another scale of FTD to assess the patients' speech. FTD as self-reported by patients was significantly associated with the synonyms test performance and severity of the reality distortion dimension. FTD as assessed by a clinician and by the patients' carers was significantly associated with executive test performance and performance in a test of associative semantics. Overall insight was significantly associated with severity of the reality distortion dimension and graded naming test performance, but was not associated with self-reported FTD or severity of FTD as assessed by the clinician or carers. The self-reported experience of FTD has different clinical and neuropsychological correlates from those of FTD as assessed by clinicians and carers. The assessment of FTD by patients and carers used along with the clinician's assessment may further the study of this group of symptoms. 2009 S. Karger AG, Basel.

  7. Insight and satisfaction with life among adolescents with mental disorders: assessing associations with self-stigma and parental insight.

    Science.gov (United States)

    Gaziel, M; Hasson-Ohayon, I; Morag-Yaffe, M; Schapir, L; Zalsman, G; Shoval, G

    2015-02-01

    The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders. Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students' Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents. Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect. The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Potato contract farming and ‘privileged spaces’: preliminary insights from rural Maharashtra

    Directory of Open Access Journals (Sweden)

    Vicol, Mark

    2014-09-01

    Full Text Available The emergence of modern value chain schemes such as contract farming in rural India are exposing households to new forms of agricultural production. Evidently, the spread of such schemes in India will have spatial implications for rural development. This short communication offers preliminary insights of the contours of these spatial implications from a case study of potato contract farming in three villages in Maharashtra, India. It is proposed that studies that combine a local-scale livelihoods approach with global value chain analysis can strengthen understanding of agricultural change and rural development by grounding value chain analysis in the place-based everyday realities of rural households. Using this approach to adopt an evolutionary view of livelihoods and value chains will lead to a much deeper understanding of possible future development pathways for rural households under conditions of agricultural transformation.

  9. Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study

    OpenAIRE

    Engh, John A; Friis, Svein; Birkenaes, Astrid B; Jónsdóttir, Halldóra; Ringen, Petter A; Ruud, Torleif; Sundet, Kjetil S; Opjordsmoen, Stein; Andreassen, Ole A

    2007-01-01

    Background Beck Cognitive Insight Scale (BCIS) has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both di...

  10. Eating disorders: Insights from imaging and behavioral approaches to treatment.

    Science.gov (United States)

    Stice, Eric; Shaw, Heather

    2017-11-01

    Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.

  11. Insight in psychotic disorder: relation with psychopathology and frontal lobe function.

    Science.gov (United States)

    Kumar, Atmesh; Sharma, Pranjal; Das, Shyamanta; Nath, Kamal; Talukdar, Uddip; Bhagabati, Dipesh

    2014-01-01

    Through conceptualising poor insight in psychotic disorders as a form of anosognosia, frontal lobe dysfunction is often ascribed a vital role in its pathogenesis. The objective of this study was to compare the relation of insight in patients with psychotic illness to that of psychopathology and frontal lobe function. Forty patients with psychotic disorder were selected from those attending the Department of Psychiatry in a tertiary care teaching hospital. The evaluation of insight was carried out using the Schedule for Assessment of Insight (SAI), that of frontal lobe function by the Frontal Assessment Battery (FAB) and psychopathology by the Brief Psychiatric Rating Scale (BPRS). The correlation coefficients were determined. A negative correlation between SAI and BPRS scores means that the BPRS score is opposite to SAI scores. When the SAI total score was compared with the FAB total score, the correlation coefficient demonstrated a positive correlation. Better insight predicted lesser psychopathology and also that poor insight would exist with greater psychopathology. Better insight predicted a higher functional status of frontal lobes and prefrontal cortex in particular. Insight deficits in schizophrenia and other psychotic illnesses are multidimensional. Integration of different aetiological factors like biological, psychopathological, environmental ones and others are necessary for a better understanding of insight in psychosis. Copyright © 2013 S. Karger AG, Basel.

  12. Predicting Eating Disorders in Women: A Preliminary Measurement Study.

    Science.gov (United States)

    Lundholm, Jean K; And Others

    1989-01-01

    Identified items from Millon Clinical Multiaxial Inventory (MCMI) that differentiated eating-disordered women (n=173) currently receiving treatment for bulimia from non-eating-disordered university women (n=265). Results identified a list of statements related to social withdrawal and depression that may be appropriate for use in assessing a…

  13. Obsessive-compulsive skin disorders: a novel classification based on degree of insight.

    Science.gov (United States)

    Zhu, Tian Hao; Nakamura, Mio; Farahnik, Benjamin; Abrouk, Michael; Reichenberg, Jason; Bhutani, Tina; Koo, John

    2017-06-01

    Individuals with obsessive-compulsive features frequently visit dermatologists for complaints of the skin, hair or nails, and often progress towards a chronic relapsing course due to the challenge associated with accurate diagnosis and management of their psychiatric symptoms. The current DSM-5 formally recognizes body dysmorphic disorder, trichotillomania, neurotic excoriation and body focused repetitive behavior disorder as psychodermatological disorders belonging to the category of Obsessive-Compulsive and Related Disorders. However there is evidence that other relevant skin diseases such as delusions of parasitosis, dermatitis artefacta, contamination dermatitis, AIDS phobia, trichotemnomania and even lichen simplex chronicus possess prominent obsessive-compulsive characteristics that do not necessarily fit the full diagnostic criteria of the DSM-5. Therefore, to increase dermatologists' awareness of this unique group of skin disorders with OCD features, we propose a novel classification system called Obsessive-Compulsive Insight Continuum. Under this new classification system, obsessive-compulsive skin manifestations are categorized along a continuum based on degree of insight, from minimal insight with delusional obsessions to good insight with minimal obsessions. Understanding the level of insight is thus an important first step for clinicians who routinely interact with these patients.

  14. Insight into mental illness and child maltreatment risk among mothers with major psychiatric disorders.

    Science.gov (United States)

    Mullick, M; Miller, L J; Jacobsen, T

    2001-04-01

    This study examined the relationship between insight into mental illness and current child maltreatment risk among mothers who had a major psychiatric disorder and who had lost custody of a child because of abuse, neglect, or having placed the child at risk of harm. Specifically, a measure of insight was examined in relation to systematically observed parenting behaviors known to be correlated with past child maltreatment and in relation to a comprehensive clinical determination of risk. Forty-four mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment. Better insight into mental illness was associated with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remained when mothers with current psychotic symptoms were excluded from the analyses. Better insight did not appear to be associated with past psychotic symptoms, maternal psychiatric diagnosis, or the mother's level of education. Insight into mental illness may function as a protective factor that influences the risk of child maltreatment in mothers with mental illness. Measures of insight could be usefully incorporated into comprehensive parenting assessments for mothers with psychiatric disorders.

  15. Transcranial magnetic stimulation and sleep disorders: pathophysiologic insights.

    Science.gov (United States)

    Nardone, Raffaele; Höller, Yvonne; Brigo, Francesco; Tezzon, Frediano; Golaszewski, Stefan; Trinka, Eugen

    2013-11-01

    The neural mechanisms underlying the development of the most common intrinsic sleep disorders are not completely known. Therefore, there is a great need for noninvasive tools which can be used to better understand the pathophysiology of these diseases. Transcranial magnetic stimulation (TMS) offers a method to noninvasively investigate the functional integrity of the motor cortex and its corticospinal projections in neurologic and psychiatric diseases. To date, TMS studies have revealed cortical and corticospinal dysfunction in several sleep disorders, with cortical hyperexcitability being a characteristic feature in some disorders (i.e., the restless legs syndrome) and cortical hypoexcitability being a well-established finding in others (i.e., obstructive sleep apnea syndrome narcolepsy). Several research groups also have applied TMS to evaluate the effects of pharmacologic agents, such as dopaminergic agent or wake-promoting substances. Our review will focus on the mechanisms underlying the generation of abnormal TMS measures in the different types of sleep disorders, the contribution of TMS in enhancing the understanding of their pathophysiology, and the potential diagnostic utility of TMS techniques. We also briefly discussed the possible future implications for improving therapeutic approaches. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. The relationship between theory of mind and insight in obsessive-compulsive disorder.

    Science.gov (United States)

    Tulacı, Rıza Gökçer; Cankurtaran, Eylem Şahin; Özdel, Kadir; Öztürk, Nefise; Kuru, Erkan; Özdemir, İlker

    2018-02-09

    It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.

  17. Affective disorders and endocrine disease. New insights from psychosomatic studies.

    Science.gov (United States)

    Fava, G A

    1994-01-01

    This is a review of psychosomatic interactions between affective disorders (depressive and anxiety disturbances, irritable mood) and endocrine disease. Particular reference is made to stressful life events in the pathogenesis of endocrine disease, psychopathology of hormonal disturbances, and pathophysiology of hypothalamic-pituitary-adrenal axis function in depression and Cushing's disease. These psychosomatic interactions may lead to appraisal of common etiological mechanisms in endocrine and psychiatric disorders, of the value of retaining the category of organic affective syndromes in psychiatric classification, and of the need for research on quality-of-life measures in endocrine disease. The establishment of "psychoendocrine units," where both endocrinologists and psychiatrists should work, is advocated. Such psychoendocrine units may serve and benefit clinical populations who currently defy traditional medical subdivisions.

  18. Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study

    Directory of Open Access Journals (Sweden)

    Jónsdóttir Halldóra

    2007-12-01

    Full Text Available Abstract Background Beck Cognitive Insight Scale (BCIS has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both diagnostic groups. Methods The BCIS self-report inventory was administered to patients with schizophrenia (n = 143, bipolar disorder (n = 92 and controls (n = 64. The 15 items of the inventory form two subscales, self-reflectiveness and self-certainty. Results The internal consistency of the subscales was good for the patient groups and the controls. The mean subscale scores were not significantly different for the three groups. Four items in subscale self-reflectiveness referring to psychotic experiences gave, however, different results in the control subjects. Self-certainty and scores on insight item PANSS correlated significantly in the schizophrenia, but not in the bipolar group. Conclusion BCIS with its two subscales seems applicable for patients with bipolar disorder as well as for patients with schizophrenia. The self-report inventory can also be applied to control subjects if the items referring to psychotic experiences are omitted. In schizophrenia high scores on self-certainty is possibly associated with poor insight of illness. For the bipolar group the subscales are largely independent of traditional insight measures.

  19. STATISTICAL INSIGHT INTO THE BINDING REGIONS IN DISORDERED HUMAN PROTEOME

    Directory of Open Access Journals (Sweden)

    Uttam Pal

    2016-03-01

    Full Text Available The human proteome contains a significant number of intrinsically disordered proteins (IDPs. They show unusual structural features that enable them to participate in diverse cellular functions and play significant roles in cell signaling and reorganization processes. In addition, the actions of IDPs, their functional cooperativity, conformational alterations and folding often accompany binding to a target macromolecule. Applying bioinformatics approaches and with the aid of statistical methodologies, we investigated the statistical parameters of binding regions (BRs found in disordered human proteome. In this report, we detailed the bioinformatics analysis of binding regions found in the IDPs. Statistical models for the occurrence of BRs, their length distribution and percent occupancy in the parent proteins are shown. The frequency of BRs followed a Poisson distribution pattern with increasing expectancy with the degree of disorderedness. The length of the individual BRs also followed Poisson distribution with a mean of 6 residues, whereas, percentage of residues in BR showed a normal distribution pattern. We also explored the physicochemical properties such as the grand average of hydropathy (GRAVY and the theoretical isoelectric points (pIs. The theoretical pIs of the BRs followed a bimodal distribution as in the parent proteins. However, the mean acidic/basic pIs were significantly lower/higher than that of the proteins, respectively. We further showed that the amino acid composition of BRs was enriched in hydrophobic residues such as Ala, Val, Ile, Leu and Phe compared to the average sequence content of the proteins. Sequences in a BR showed conformational adaptability mostly towards flexible coil structure and followed by helix, however, the ordered secondary structural conformation was significantly lower in BRs than the proteins. Combining and comparing these statistical information of BRs with other methods may be useful for high

  20. [Mental disorders in digestive system diseases - internist's and psychiatrist's insight].

    Science.gov (United States)

    Kukla, Urszula; Łabuzek, Krzysztof; Chronowska, Justyna; Krzystanek, Marek; Okopień, BogusŁaw

    2015-05-01

    Mental disorders accompanying digestive system diseases constitute interdisciplinary yet scarcely acknowledged both diagnostic and therapeutic problem. One of the mostly recognized examples is coeliac disease where patients endure the large spectrum of psychopathological symptoms, starting with attention deficit all the way down to the intellectual disability in extreme cases. It has not been fully explained how the pathomechanism of digestive system diseases affects patient's mental health, however one of the hypothesis suggests that it is due to serotonergic or opioid neurotransmission imbalance caused by gluten and gluten metabolites effect on central nervous system. Behavioral changes can also be invoked by liver or pancreatic diseases, which causes life-threatening abnormalities within a brain. It occurs that these abnormalities reflexively exacerbate the symptoms of primary somatic disease and aggravate its course, which worsens prognosis. The dominant mental disease mentioned in this article is depression which because of its effect on a hypothalamuspituitary- adrenal axis and on an autonomic nervous system, not only aggravates the symptoms of inflammatory bowel diseases but may accelerate their onset in genetically predisposed patients. Depression is known to negatively affects patients' ability to function in a society and a quality of their lives. Moreover, as far as children are concerned, the occurrence of digestive system diseases accompanied by mental disorders, may adversely affect their further physical and psychological development, which merely results in worse school performance. All those aspects of mental disorders indicate the desirability of the psychological care for patients with recognized digestive system disease. The psychological assistance should be provided immediately after diagnosis of a primary disease and be continued throughout the whole course of treatment. © 2015 MEDPRESS.

  1. Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders

    Science.gov (United States)

    White, Susan W.; Ollendick, Thomas; Scahill, Lawrence; Oswald, Donald; Albano, Anne Marie

    2009-01-01

    Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint,…

  2. Insights in Anaphylaxis and Clonal Mast Cell Disorders

    Directory of Open Access Journals (Sweden)

    David González-de-Olano

    2017-07-01

    Full Text Available The prevalence of anaphylaxis among patients with clonal mast cell disorders (MCD is clearly higher comparing to the general population. Due to a lower frequency of symptoms outside of acute episodes, clonal MCD in the absence of skin lesions might sometimes be difficult to identify which may lead to underdiagnosis, and anaphylaxis is commonly the presenting symptom in these patients. Although the release of mast cell (MC mediators upon MC activation might present with a wide variety of symptoms, particular clinical features typically characterize MC mediator release episodes in patients with clonal MCD without skin involvement. Final diagnosis requires a bone marrow study, and it is recommended that this should be done in reference centers. In this article, we address the main triggers for anaphylaxis, risk factors, clinical presentation, diagnosis, and management of patients with MC activation syndromes (MCASs, with special emphasis on clonal MCAS [systemic mastocytosis and mono(clonal MC activations syndromes].

  3. A cross-sectional study of insight and family accommodation in pediatric obsessive-compulsive disorder

    Science.gov (United States)

    2013-01-01

    Background Factors predicting treatment outcome in pediatric patients with obsessive-compulsive disorder (OCD) include disease severity, functional impairment, comorbid disorders, insight, and family accommodation (FA). Treatment of pediatric OCD is often only partly successful as some of these predictors are not targeted with conventional therapy. Among these, insight and FA were identified to be modifiable predictors of special relevance to pediatric OCD. Despite their clinical relevance, insight and FA remain understudied in youth with OCD. This study examined the clinical correlates of insight and FA and determined whether FA mediates the relationship between symptom severity and functional impairment in pediatric OCD. Methods This was a cross-sectional, outpatient study. Thirty-five treatment-naive children and adolescentswith DSM-IV diagnosis of OCD (mean age: 13.11 ± 3.16; 54.3% males) were included. Standard questionnaires were administered for assessing the study variables. Insight and comorbidities were assessed based on clinician’s interview. Subjects were categorized as belonging to a high insight or a low insight group, and the differences between these two groups were analyzed using ANOVA. Pearson’s correlation coefficients were calculated for the remaining variables of interest. Mediation analysis was carried out using structural equation modeling. Results Relative to those in the high insight group, subjects in the low insight group were younger, had more severe disease and symptoms, and were accommodated to a greater extent by their families. In addition, comorbid depression was more frequent in subjects belonging to the low insight group. Family accommodation was positively related to disease severity, symptom severity, and functional impairment. Family accommodation totally mediated the relationship between symptom severity and functional impairment. Conclusions Results support the differences in the diagnostic criteria between adult and

  4. Aripiprazole augmentation in poor insight obsessive-compulsive disorder: a case report

    Directory of Open Access Journals (Sweden)

    Vinciguerra Valentina

    2008-12-01

    Full Text Available Abstract Background Obsessive-compulsive disorder is associated with a relevant impairment in social and interpersonal functioning and severe disability. This seems to be particularly true for the poor insight subtype, characterised by a lack of consciousness of illness and, consequently, compliance with treatment. Poor responsiveness to serotonergic drugs in poor insight obsessive-compulsive patients may also require an augmentation therapy with atypical antipsychotics. Methods We reviewed a case in which a patient with a long history of poor insight obsessive-compulsive disorder was treated with a high dosage of serotonin reuptake inhibitors. Results The treatment resulted in a poor outcome. This patient was therefore augmentated with aripiprazole. Conclusion Doctors should consider aripiprazole as a possible augmentation strategy for serotonergic poor responder obsessive-compulsive patients, but further research on these subjects is needed.

  5. Effect of video self-observations vs. observations of others on insight in psychotic disorders.

    Science.gov (United States)

    David, Anthony S; Chis Ster, Irina; Zavarei, Hooman

    2012-04-01

    Improving insight in patients with schizophrenia and related disorders is a worthwhile goal. Previous work has suggested that patients' insight may improve if they see videos of themselves taken when ill. Our aim was to test the hypothesis that schizophrenia patients improve their insight after viewing videos of themselves when unwell more so than after viewing an actor. Forty patients admitted with an acute psychotic disorder underwent a videotaped recording of a clinical interview. The patients were then randomized to viewing this or a "control" video of a same-sex actor displaying psychotic symptoms approximately 3 weeks later. Insight, psychopathology, and mood were assessed before and 24 to 48 hours after viewing the videos. All participants showed general improvement across all measures. There was a trend for scores on the Schedule for the Assessment of Insight to improve more in those who viewed themselves when ill, but there were no clear statistically significant differences between the "self" and "other" video groups. In conclusion, video self-confrontation seems to be a safe and potentially effective means of enhancing insight, but evidence for a specific effect is lacking.

  6. Self-disorders and schizophrenia: a phenomenological reappraisal of poor insight and noncompliance.

    Science.gov (United States)

    Henriksen, Mads G; Parnas, Josef

    2014-05-01

    Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patients have no or only partial insight and consequently do not comply with treatment is rooted in the nature of their anomalous self-experiences (ie, self- disorders) and the related articulation of their psychotic symptoms. We argue that self-disorders destabilize the patients' experiential framework, thereby weakening their basic sense of reality (natural attitude) and enabling another sense of reality (solipsistic attitude) to emerge and coexist. This coexistence of attitudes, which Bleuler termed "double bookkeeping," is, in our view, central to understanding what poor insight in schizophrenia really is. We suggest that our phenomenologically informed account of poor insight may have important implications for early intervention, psychoeducation, and psychotherapy for schizophrenia.

  7. Unraveling the insight paradox: One-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders.

    Science.gov (United States)

    Chio, Floria H N; Mak, Winnie W S; Chan, Randolph C H; Tong, Alan C Y

    2018-01-30

    The promotion of insight among people with schizophrenia spectrum disorders has posed a dilemma to service providers as higher insight has been linked to positive clinical outcomes but negative psychological outcomes. The negative meaning that people attached to the illness (self-stigma content) and the recurrence of such stigmatizing thoughts (self-stigma process) may explain why increased insight is associated with negative outcomes. The present study examined how the presence of high self-stigma content and self-stigma process may contribute to the negative association between insight and life satisfaction. A total of 181 people with schizophrenia spectrum disorders were assessed at baseline. 130 and 110 participants were retained and completed questionnaire at 6-month and 1-year follow-up, respectively. Results showed that baseline insight was associated with lower life satisfaction at 6-month when self-stigma process or self-stigma content was high. Furthermore, baseline insight was predictive of better life satisfaction at 1-year follow-up when self-stigma process was low. Findings suggested that the detrimental effects of insight can be a result from both the presence of cognitive content and habitual process of self-stigma. Future insight promotion interventions should also address self-stigma content and process among people with schizophrenia spectrum disorders so as to maximize the beneficial effects of insight. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Abnormal small-world brain functional networks in obsessive-compulsive disorder patients with poor insight.

    Science.gov (United States)

    Lei, Hui; Cui, Yan; Fan, Jie; Zhang, Xiaocui; Zhong, Mingtian; Yi, Jinyao; Cai, Lin; Yao, Dezhong; Zhu, Xiongzhao

    2017-09-01

    There are limited data on neurobiological correlates of poor insight in obsessive-compulsive disorder (OCD). This study explored whether specific changes occur in small-world network (SWN) properties in the brain functional network of OCD patients with poor insight. Resting-state electroencephalograms (EEGs) were recorded for 12 medication-free OCD patients with poor insight, 50 medication-free OCD patients with good insight, and 36 healthy controls. Both of the OCD groups exhibited topological alterations in the brain functional network characterized by abnormal small-world parameters at the beta band. However, the alterations at the theta band only existed in the OCD patients with poor insight. A relatively small sample size. Subjects were naïve to medications and those with Axis I comorbidity were excluded, perhaps limiting generalizability. Disrupted functional integrity at the beta bands of the brain functional network may be related to OCD, while disrupted functional integrity at the theta band may be associated with poor insight in OCD patients, thus this study might provide novel insight into our understanding of the pathophysiology of OCD. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. The influence of current mood state, number of previous affective episodes and predominant polarity on insight in bipolar disorder.

    Science.gov (United States)

    de Assis da Silva, Rafael; Mograbi, Daniel C; Camelo, Evelyn Vieira Miranda; Peixoto, Ursula; Santana, Cristina Maria Teixeira; Landeira-Fernandez, Jesus; Morris, Robin G; Cheniaux, Elie

    2017-11-01

    Although many studies have explored the effect of current affective episodes on insight into bipolar disorder, the potential interaction between current mood state and previous affective episodes has not been consistently investigated. To explore the influence of dominant polarity, number of previous affective episodes and current affective state on insight in bipolar disorder patients in euthymia or mania. A total of 101 patients with bipolar disorder were recruited for the study, including 58 patients in euthymia (30 with no defined predominant polarity and 28 with manic predominant polarity) and 43 in mania (26 with no defined predominant polarity and 17 with manic predominant polarity). Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. Bipolar disorder patients in mania had worse insight than those in euthymia, with no effect of dominant polarity. In addition, positive psychotic symptoms showed a significant effect on insight and its inclusion as a covariate eliminated differences related to mood state. Finally, the number of previous manic or depressive episodes did not correlate with insight level. Mania is a predictor of loss of insight into bipolar disorder. However, it is possible that its contribution is linked to the more frequent presence of psychotic symptoms in this state. Dominant polarity and number/type of previous affective episodes have a limited impact on insight.

  10. Does mindfulness have potential in eating disorders prevention? A preliminary controlled trial with young adult women.

    Science.gov (United States)

    Atkinson, Melissa J; Wade, Tracey D

    2016-06-01

    This preliminary randomized controlled trial assessed the feasibility of a pilot mindfulness-based intervention with respect to reducing the risk of eating disorders in young women. Forty-four young adult women with body image concerns (Mage  = 20.57, SD = 3.22) were randomly allocated to a mindfulness-based or a dissonance-based intervention (3 × 1 h weekly sessions), or to assessment-only control. Self-report measures of eating disorder risk factors, symptoms and related psychosocial impairment were compared at baseline, post-intervention, and at 1- and 6-month follow up. At post-intervention, acceptability ratings for both interventions were high. Mindfulness participants demonstrated statistically significant improvements relative to control at post-intervention for weight and shape concern, dietary restraint, thin ideal internalization, eating disorder symptoms and related psychosocial impairment; however, these gains were largely lost over follow up. Dissonance participants did not show statistically significant improvements relative to control on any outcomes, despite small to moderate effect sizes. These preliminary findings demonstrate the acceptability and short-term efficacy of a mindfulness-based approach to reducing the risk of disordered eating in young women. This provides support for the continued evaluation of mindfulness in the prevention and early intervention of eating disorders, with increased efforts to produce maintenance of intervention gains. © 2014 Wiley Publishing Asia Pty Ltd.

  11. O conceito do insight em pacientes com transtorno obsessivo-compulsivo The concept of insight in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Júlia M. Fontenelle

    2010-03-01

    Full Text Available OBJETIVO: Atualizar os clínicos sobre a existência de um possível subtipo do transtorno obsessivo-compulsivo caracterizado por pouco insight. MÉTODO: Revisão opinativa baseada em estudos indexados na base de dados PubMed e PsychINFO, identificados por meio dos unitermos "obsessive-compulsive disorder" e "insight" ou "ego-dystonic" e publicados entre 1966 e outubro de 2009. Os resultados foram examinados de acordo com a estratégia utilizada para abordar o insight, i.e. categórica vs. dimensional. RESULTADOS: Análise dos estudos nos permitiu identificar pontos que colocam em dúvida a existência de um subtipo do transtorno obsessivo-compulsivo bem delimitado caracterizado por pouco insight. Estes pontos incluem 1 prevalência extremamente variável do transtorno obsessivo-compulsivo com insight reduzido encontrada em estudos categóricos, 2 homogeneidade dos achados fenotípicos (i.e. maior gravidade associados a baixo insight em estudos categóricos e dimensionais e 3 ausência de estudos que investigam "zonas de raridade" entre as formas de transtorno obsessivo-compulsivo com pouco e bom insight. CONCLUSÃO: Embora uma abordagem categórica do insight no transtorno obsessivo-compulsivo seja importante em ambientes clínicos, uma vez que neles existem demandas prementes para tomada de decisões, a abordagem dimensional do insight parece refletir de forma mais fidedigna o fenômeno apresentado pelos pacientes em tela.OBJECTIVE: To update clinicians regarding the existence of a putative subtype of obsessive-compulsive disorder based on poor insight. METHOD: Opinionative review based on studies indexed in the PubMed and PsychINFO databases, identified by means of the keywords "obsessive-compulsive disorder" AND "insight" OR "ego-syntonic", and published between 1966 and October 2009. The results were analyzed according to the approach adopted, i.e. a categorical or dimensional view of insight in obsessive-compulsive disorder. RESULTS: The

  12. When words fail us: insights into language processing from developmental and acquired disorders.

    Science.gov (United States)

    Bishop, Dorothy V M; Nation, Kate; Patterson, Karalyn

    2014-01-01

    Acquired disorders of language represent loss of previously acquired skills, usually with relatively specific impairments. In children with developmental disorders of language, we may also see selective impairment in some skills; but in this case, the acquisition of language or literacy is affected from the outset. Because systems for processing spoken and written language change as they develop, we should beware of drawing too close a parallel between developmental and acquired disorders. Nevertheless, comparisons between the two may yield new insights. A key feature of connectionist models simulating acquired disorders is the interaction of components of language processing with each other and with other cognitive domains. This kind of model might help make sense of patterns of comorbidity in developmental disorders. Meanwhile, the study of developmental disorders emphasizes learning and change in underlying representations, allowing us to study how heterogeneity in cognitive profile may relate not just to neurobiology but also to experience. Children with persistent language difficulties pose challenges both to our efforts at intervention and to theories of learning of written and spoken language. Future attention to learning in individuals with developmental and acquired disorders could be of both theoretical and applied value.

  13. [Relationship of insight with depression and suicidal ideation in psychotic disorders].

    Science.gov (United States)

    Patelaros, E; Zournatzis, E; Kontstantakopoulos, G

    2015-01-01

    The associations of insight into psychosis (i.e., awareness of illness) with clinical variables have been examined by a great number of studies. Most of these studies revealed that the level of insight is negatively correlated with psychotic symptoms but positively correlated with depression and suicidal ideation. The aim of this study was to test these findings in a Greek sample of patients. Forty-three outpatients (30 men and 13 women) with schizophrenia or delusional disorder being followed up at the Mental Health Centre of Kavala took part in the study. Patients with bipolar or schizoaffective disorder were excluded. Patients' mean age was 40.7 years and the mean duration of illness was 18.67 years. All participants were under treatment and clinically stable at the time of the study. We used the Positive and Negative Syndrome Scale (PANSS) for the assessment of positive and negative symptoms, the Schedule for the Assessment of Insight-Expanded (SAI-E) to assess the insight into psychosis, and the Montgomery-Asberg Depression Rating Scale (MADRS) for the evaluation of depression recording separately the score for item 10 as an estimate of suicidal ideation. All the scales used have been adapted to Greek population. We used Spearman rho coefficient to assess the strength of correlations between the scales because the distributions of some scores were not normal. In order to assess the predictive value of insight for depression and suicidal ideation, we used hierarchical linear regression analysis. Correlation coefficients between SAI-E and the clinical scales of psychopathology, depression and suicide ideation was statistically significant at the pregression analysis showed that our model of positive and negative psychopathology and insight explained 47.4% of the variance of depression and 32.2% of the variance of suicidal ideation. The predictive value of insight was critically important, because only after the introduction of the SAI-E score in the analysis our

  14. Implementation of transdiagnostic treatment for emotional disorders in residential eating disorder programs: A preliminary pre-post evaluation.

    Science.gov (United States)

    Thompson-Brenner, Heather; Boswell, James F; Espel-Huynh, Hallie; Brooks, Gayle; Lowe, Michael R

    2018-03-19

    Data are lacking from empirically supported therapies implemented in residential programs for eating disorders (EDs). Common elements treatments may be well-suited to address the complex implementation and treatment challenges that characterize these settings. This study assessed the preliminary effect of implementing a common elements therapy on clinician treatment delivery and patient (N = 616) symptom outcomes in two residential ED programs. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders was adapted to address ED and co-occurring psychopathology and implemented across sites. Therapists' treatment fidelity was rated independently to assess implementation success. Additionally, longitudinal (pre-post) design compared treatment outcomes among patients treated before and after implementation. Patient outcomes included ED and depressive symptoms, experiential avoidance, anxiety sensitivity, and mindfulness. Following training and implementation, clinicians demonstrated adequate to good fidelity. Relative to pre-implementation, post-implementation patients showed significantly greater improvements in experiential avoidance, anxiety sensitivity, and mindfulness at discharge (ps ≤ .04) and more favorable outcomes on ED symptom severity, depression, and experiential avoidance at 6-month follow up (ps ≤ .0001). Preliminary pilot data support the feasibility of implementing transdiagnostic common elements therapy in residential ED treatment, and suggest that implementation may benefit transdiagnostic outcomes for patients.

  15. Group Cognitive Behavioural Therapy and Group Recreational Activity for Adults with Autism Spectrum Disorders: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Hesselmark, Eva; Plenty, Stephanie; Bejerot, Susanne

    2014-01-01

    Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This "preliminary" randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive…

  16. Growth hormone response to guanfacine in boys with attention deficit hyperactivity disorder: a preliminary study.

    Science.gov (United States)

    Halperin, Jeffrey M; Newcorn, Jeffrey H; McKay, Kathleen E; Siever, Larry J; Sharma, Vanshdeep

    2003-01-01

    This preliminary study evaluated a method for assessing central noradrenergic function in children via the growth hormone response to a single dose of the alpha-2 adrenergic receptor agonist guanfacine and examined whether this measure distinguishes between attention deficit hyperactivity disorder (ADHD) boys with and without reading disabilities (RD). Plasma growth hormone was assessed before and after the oral administration of guanfacine and placebo in boys with ADHD who were divided into subgroups based on the presence (n = 3) or absence (n = 5) of RD. Guanfacine and placebo conditions did not differ at baseline, but peak growth hormone was significantly higher following guanfacine. The increase in growth hormone following guanfacine was significantly greater in boys without RD as compared to those with RD, with no overlap between the groups. Consistent with findings using peripheral measures of noradrenergic function, these preliminary data suggest that ADHD boys with and without RD may differ in central noradrenergic function.

  17. A Controlled Randomized Preliminary Trial of a Modified Dissonance-Based Eating Disorder Intervention Program.

    Science.gov (United States)

    Green, M A; Willis, M; Fernandez-Kong, K; Reyes, S; Linkhart, R; Johnson, M; Thorne, T; Lindberg, J; Kroska, E; Woodward, H

    2017-12-01

    We conducted a controlled randomized preliminary trial of a modified dissonance-based eating disorder program (n = 24) compared to an assessment-only control condition (n = 23) via a longitudinal design (baseline, postintervention, 2-month follow-up) in a community sample of women (N = 47) with clinical (n = 22) and subclinical (n = 25) eating disorder symptoms. The traditional content of the Body Project, a dissonance-based eating disorder prevention program, was modified to include verbal, written, and behavioral exercises designed to dissuade self-objectification and maladaptive social comparison. Women with clinical and subclinical symptoms were included in the target audience to investigate both the treatment and the indicated prevention utility of the modified dissonance program. Body dissatisfaction, self-esteem, self-objectification, thin-ideal internalization, maladaptive social comparison, trait anxiety, and eating disorder symptoms were evaluated in the control and the modified dissonance condition at baseline, postintervention, and 2-month follow-up. We predicted a statistically significant 2 (condition: control, modified dissonance) x 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial multivariate analyses of variance results. Results confirmed this hypothesis. Eating disorder risk factors and symptoms decreased significantly among participants in the modified dissonance condition at postintervention and 2-month follow-up compared to baseline; symptom improvement was greater among participants in the modified compared to the control condition. A secondary analysis indicated symptom improvement did not vary as a function of symptom status (clinical, subclinical), suggesting the program is efficacious in both indicated prevention and treatment applications. Results provide preliminary support for the modified dissonance program. © 2017 Wiley Periodicals, Inc.

  18. Secondary School Students' Epistemic Insight into the Relationships Between Science and Religion—A Preliminary Enquiry

    Science.gov (United States)

    Billingsley, Berry; Taber, Keith; Riga, Fran; Newdick, Helen

    2013-08-01

    A number of previous studies have shown that there is a widespread view among young people that science and religion are opposed. In this paper, we suggest that it requires a significant level of what can be termed "epistemic insight" to access the idea that some people see science and religion as compatible while others do not. To explore this further, we draw on previous work to devise a methodology to discover students' thinking about apparent contradictions between scientific and religious explanations of the origins of the universe. In our discussion of the findings, we highlight that students' epistemic insight in this context does seem in many cases to be limited and we outline some of the issues emerging from the study that seem to boost or limit students' progress in this area.

  19. Preliminary Evidence for Cognitive Mediation During Cognitive–Behavioral Therapy of Panic Disorder

    Science.gov (United States)

    Hofmann, Stefan G.; Suvak, Michael K.; Barlow, David H.; Shear, M. Katherine; Meuret, Alicia E.; Rosenfield, David; Gorman, Jack M.; Woods, Scott W.

    2007-01-01

    Cognitive–behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT. PMID:17563154

  20. Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony Ft; Mulder, Cornelis L

    2016-01-01

    Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.

  1. New technologies provide insights into genetic basis of psychiatric disorders and explain their co-morbidity.

    Science.gov (United States)

    Rudan, Igor

    2010-06-01

    The completion of Human Genome Project and the "HapMap" project was followed by translational activities from companies within the private sector. This led to the introduction of genome-wide scans based on hundreds of thousands of single nucleotide polymorphysms (SNP). These scans were based on common genetic variants in human populations. This new and powerful technology was then applied to the existing DNA-based datasets with information on psychiatric disorders. As a result, an unprecedented amount of novel scientific insights related to the underlying biology and genetics of psychiatric disorders was obtained. The dominant design of these studies, so called "genome-wide association studies" (GWAS), used statistical methods which minimized the risk of false positive reports and provided much greater power to detect genotype-phenotype associations. All findings were entirely data-driven rather than hypothesis-driven, which often made it difficult for researchers to understand or interpret the findings. Interestingly, this work in genetics is indicating how non-specific some genes are for psychiatric disorders, having associations in common for schizophrenia, bipolar disorder and autism. This suggests that the earlier stages of psychiatric disorders may be multi-valent and that early detection, coupled with a clearer understanding of the environmental factors, may allow prevention. At the present time, the rich "harvest" from GWAS still has very limited power to predict the variation in psychiatric disease status at individual level, typically explaining less than 5% of the total risk variance. The most recent studies of common genetic variation implicated the role of major histocompatibility complex in schizophrenia and other disorders. They also provided molecular evidence for a substantial polygenic component to the risk of psychiatric diseases, involving thousands of common alleles of very small effect. The studies of structural genetic variation, such as copy

  2. Predicting methylphenidate response in attention deficit hyperactivity disorder: a preliminary study.

    Science.gov (United States)

    Johnston, Blair A; Coghill, David; Matthews, Keith; Steele, J Douglas

    2015-01-01

    Methylphenidate (MPH) is established as the main pharmacological treatment for patients with attention deficit hyperactivity disorder (ADHD). Whilst MPH is generally a highly effective treatment, not all patients respond, and some experience adverse reactions. Currently, there is no reliable method to predict how patients will respond, other than by exposure to a trial of medication. In this preliminary study, we sought to investigate whether an accurate predictor of clinical response to methylphenidate could be developed for individual patients, using sociodemographic, clinical and neuropsychological measures. Of the 43 boys with ADHD included in this proof-of-concept study, 30 were classed as responders and 13 as non-responders to MPH, with no significant differences in age nor verbal intelligence quotient (IQ) between the groups. Here we report the application of a multivariate analysis approach to the prediction of clinical response to MPH, which achieved an accuracy of 77% (p = 0.005). The most important variables to the classifier were performance on a 'go/no go' task and comorbid conduct disorder. This preliminary study suggested that further investigation is merited. Achieving a highly significant accuracy of 77% for the prediction of MPH response is an encouraging step towards finding a reliable and clinically useful method that could minimise the number of children needlessly being exposed to MPH. © The Author(s) 2014.

  3. Comparison of brain connectivity between Internet gambling disorder and Internet gaming disorder: A preliminary study.

    Science.gov (United States)

    Bae, Sujin; Han, Doug Hyun; Jung, Jaebum; Nam, Ki Chun; Renshaw, Perry F

    2017-12-01

    Background and aims Given the similarities in clinical symptoms, Internet gaming disorder (IGD) is thought to be diagnostically similar to Internet-based gambling disorder (ibGD). However, cognitive enhancement and educational use of Internet gaming suggest that the two disorders derive from different neurobiological mechanisms. The goal of this study was to compare subjects with ibGD to those with IGD. Methods Fifteen patients with IGD, 14 patients with ibGD, and 15 healthy control subjects were included in this study. Resting-state functional magnetic resonance imaging data for all participants were acquired using a 3.0 Tesla MRI scanner (Philips, Eindhoven, The Netherlands). Seed-based analyses, the three brain networks of default mode, cognitive control, and reward circuitry, were performed. Results Both IGD and ibGD groups demonstrated decreased functional connectivity (FC) within the default-mode network (DMN) (family-wise error p < .001) compared with healthy control subjects. However, the IGD group demonstrated increased FC within the cognitive network compared with both the ibGD (p < .01) and healthy control groups (p < .01). In contrast, the ibGD group demonstrated increased FC within the reward circuitry compared with both IGD (p < .01) and healthy control subjects (p < .01). Discussion and conclusions The IGD and ibGD groups shared the characteristic of decreased FC in the DMN. However, the IGD group demonstrated increased FC within the cognitive network compared with both ibGD and healthy comparison groups.

  4. Family-based treatment of eating disorders in adolescents: current insights

    Directory of Open Access Journals (Sweden)

    Rienecke RD

    2017-06-01

    Full Text Available Renee D Rienecke1–3 1Department of Pediatrics, 2Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, 3Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA Abstract: Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment. Keywords: eating disorders, adolescents, family-based therapy, anorexia nervosa, bulimia nervosa

  5. Towards understanding hydroclimatic change in Victoria, Australia – preliminary insights into the "Big Dry"

    Directory of Open Access Journals (Sweden)

    A. S. Kiem

    2010-03-01

    Full Text Available Since the mid-1990s the majority of Victoria, Australia, has experienced severe drought conditions (i.e. the "Big Dry" characterized by streamflow that is the lowest in approximately 80 years of record. While decreases in annual and seasonal rainfall totals have also been observed, this alone does not seem to explain the observed reduction in flow. In this study, we investigate the large-scale climate drivers for Victoria and demonstrate how these modulate the regional scale synoptic patterns, which in turn alter the way seasonal rainfall totals are compiled and the amount of runoff per unit rainfall that is produced. The hydrological implications are significant and illustrate the need for robust hydrological modelling, that takes into account insights into physical mechanisms that drive regional hydroclimatology, in order to properly understand and quantify the impacts of climate change (natural and/or anthropogenic on water resources.

  6. Do district health systems perform differently because of their managers? Preliminary insights from Indonesia

    Directory of Open Access Journals (Sweden)

    Augustine Asante

    2015-07-01

    Full Text Available District health systems (DHS are central to the global efforts to improve health outcomes but many remain ineffective. In many lowresource settings, despite the generally weak DHS there is evidence that some districts consistently perform well against the odds, and this is often attributed to the calibre of managers leading such districts and their management and leadership (M&L skills. This paper examines the M&L practices of district health managers in high and low performing districts in Indonesia in an attempt to understand whether the differences in the performance of DHS can be explained, at least in part, by the differences in the performance of their health managers. We employed a mixed methods case study design focusing on two purposefully selected districts. Data were collected in 2011 using questionnaires and in-depth interviews. The preliminary results suggest that M&L practices of managers in the high and low performing districts are similar and provide little explanation for the differences in the performance of the two DHS. Contextual and health system factors offered a much better explanation for the variations in DHS performance.

  7. REM sleep behaviour disorder: prodromal and mechanistic insights for Parkinson's disease.

    Science.gov (United States)

    Tekriwal, Anand; Kern, Drew S; Tsai, Jean; Ince, Nuri F; Wu, Jianping; Thompson, John A; Abosch, Aviva

    2017-05-01

    Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterised by complex motor enactment of dreams and is a potential prodromal marker of Parkinson's disease (PD). Of note, patients with PD observed during RBD episodes exhibit improved motor function, relative to baseline states during wake periods. Here, we review recent epidemiological and mechanistic findings supporting the prodromal value of RBD for PD, incorporating clinical and electrophysiological studies. Explanations for the improved motor function during RBD episodes are evaluated in light of recent publications. In addition, we present preliminary findings describing changes in the activity of the basal ganglia across the sleep-wake cycle that contribute to our understanding of RBD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. SA45. Amotivation in Schizophrenia, Bipolar Disorder, and Major Depressive Disorder: A Preliminary Comparison Study

    Science.gov (United States)

    Zou, Ying-min; Ni, Ke; Wang, Yang-yu; Yu, En-qing; Lui, Simon S. Y.; Cheung, Eric F. C.; Chan, Raymond C. K.

    2017-01-01

    Abstract Background: Deficits in reward processing, such as approaching motivation, reward learning and effort-based decision-making, have been observed in patients with schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). However, little is known about the nature of reward-processing deficits in these 3 diagnostic groups. The present study aimed to compare and contrast amotivation in these 3 diagnostic groups using an effort-based decision-making task. Methods: Sixty patients (19 SCZ patients, 18 BD patients and 23 MDD patients) and 27 healthy controls (HC) were recruited for the present study. The Effort Expenditure for Reward Task (EEfRT) was administered to evaluate their effort allocation pattern. This task required participants to choose easy or hard tasks in response to different levels of reward magnitude and reward probability. Results: Results showed that SCZ, BD, and MDD patients chose fewer hard tasks compared to HC. As reward magnitude increased, MDD patients made the least effort to gain reward compared to the other groups. When reward probability was intermediate, MDD patients chose fewer hard tasks than SCZ patients, whereas BD patients and HC chose more hard tasks than MDD and SCZ patients. When the reward probability was high, all 3 groups of patients tried fewer hard tasks than HC. Moreover, SCZ and MDD patients were less likely to choose hard tasks than BD patients and HC in the intermediate estimated value conditions. However, in the highest estimated value condition, there was no group difference in hard task choices between these 3 clinical groups, and they were all less motivated than HC. Conclusion: SCZ, BD, and MDD patients shared common deficits in gaining reward if the reward probability and estimated value were high. SCZ and MDD patients showed less motivation than BD patients in gaining reward when the reward probability and estimated value was intermediate.

  9. Sleep-Related Disorders in Children with Attention-Deficit Hyperactivity Disorder: Preliminary Results of a Full Sleep Assessment Study.

    Science.gov (United States)

    Miano, Silvia; Esposito, Maria; Foderaro, Giuseppe; Ramelli, Gian Paolo; Pezzoli, Valdo; Manconi, Mauro

    2016-11-01

    We present the preliminary results of a prospective case-control sleep study in children with a diagnosis of attention-deficit hyperactivity disorder (ADHD). A deep sleep assessment including sleep questionnaires, sleep habits, a video-polysomnographic recording with full high-density electroencephalography (EEG) and cardiorespiratory polygraphy, multiple sleep latency test, and 1-week actigraphic recording were performed to verify whether children with ADHD may be classified into one of the following five phenotypes: (1) hypoarousal state, resembling narcolepsy, which may be considered a "primary" form of ADHD; (2) delayed sleep onset insomnia; (3) sleep-disordered breathing; (4) restless legs syndrome and/or periodic limb movements; and (5) sleep epilepsy and/or EEG interictal epileptiform discharges. Fifteen consecutive outpatients with ADHD were recruited (two female, mean age 10.6 ± 2.2, age range 8-13.7 years) over 6 months. The narcolepsy-like sleep phenotype was observed in three children, the sleep onset insomnia phenotype was observed in one child, mild obstructive sleep apnea was observed in three children, sleep hyperkinesia and/or PLMs were observed in five children, while IEDs and or nocturnal epilepsy were observed in three children. Depending on the sleep phenotype, children received melatonin, iron supplementation, antiepileptic drugs, or stimulants. Our study further highlights the need to design an efficient sleep diagnostic algorithm for children with ADHD, thereby more accurately identifying cases in which a full sleep assessment is indicated. © 2016 John Wiley & Sons Ltd.

  10. Predictors of orthorexic behaviours in patients with eating disorders: a preliminary study.

    Science.gov (United States)

    Brytek-Matera, Anna; Rogoza, Radosław; Gramaglia, Carla; Zeppegno, Patrizia

    2015-10-15

    The construct of orthorexia in eating disorders (EDs) has received very little attention despite clinical observations of a possible overlap between the two. The aim of this study was: 1) to assess orthorexic behaviours, eating disorder pathology and attitudinal body image in ED patients; 2) to identify possible predictors of orthorexia nervosa among ED patients. Fifty-two women diagnosed with EDs were recruited. Patients' assessment included the following: the ORTO-15 test (Polish version) for orthorexic behaviours; the Eating Attitude Test-26 (EAT-26) to identify ED symptoms; the Multidimensional Body-Self Relations Questionnaire (Polish version) to assess body image. A latent class analysis was performed and differences between identified classes were assessed. The main differences concerned weight, ED pathology and orthorexic behaviours within the same group of ED patients. In order to examine predictors of orthorexia nervosa, we investigated a structural equation model, which excellently fitted to the data (χ(2)(17) = 23.05; p = .148; CFI = .962; RMSEA = .08; p = .25; SRMR = .05). In ED patients, orthorexic behaviour was negatively predicted by eating pathology, weight concern, health orientation and appearance orientation. The assessment of the orthorexia construct in EDs may add to the paucity of studies about this issue and may help to clarify the relationship between the two. Differences and similarities seem to exist between these disorders, and may benefit from specific treatment approaches. Moreover, these preliminary findings open tracks for future research in the field of the psychology of eating.

  11. Speed and accuracy of facial expression classification in avoidant personality disorder: a preliminary study.

    Science.gov (United States)

    Rosenthal, M Zachary; Kim, Kwanguk; Herr, Nathaniel R; Smoski, Moria J; Cheavens, Jennifer S; Lynch, Thomas R; Kosson, David S

    2011-10-01

    The aim of this preliminary study was to examine whether individuals with avoidant personality disorder (APD) could be characterized by deficits in the classification of dynamically presented facial emotional expressions. Using a community sample of adults with APD (n = 17) and non-APD controls (n = 16), speed and accuracy of facial emotional expression recognition was investigated in a task that morphs facial expressions from neutral to prototypical expressions (Multi-Morph Facial Affect Recognition Task; Blair, Colledge, Murray, & Mitchell, 2001). Results indicated that individuals with APD were significantly more likely than controls to make errors when classifying fully expressed fear. However, no differences were found between groups in the speed to correctly classify facial emotional expressions. The findings are some of the first to investigate facial emotional processing in a sample of individuals with APD and point to an underlying deficit in processing social cues that may be involved in the maintenance of APD.

  12. The relationship between insight and the level of expressed emotion in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Ozkiris, Ayse; Essizoglu, Altan; Gulec, Gulcan; Aksaray, Gokay

    2015-04-01

    The aim of this study is firstly to compare the obsessive-compulsive disorder (OCD) patients with good insight and OCD patients with poor insight in terms of socio-demographic and clinical features; to investigate the relation between insight and the level of the expressed emotion (EE) in the patients; and lastly to specify the factors that predict level of insight. OCD patients with good insight and patients with poor insight were compared in terms of clinical features and the perceived EE level of the patients and the individuals that they live with in order to specify the factors that predict the insight level, and to investigate the relationship between insight level and EE. It was found that the total Expressed Emotion Scale, total Level of Expressed Emotion (LEE), LEE-Emotional Response and LEE-Tolerance/Expectation subscale scores of the group comprised of patients with poor insight are higher than the other group. The results also show that the duration of illness and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score predict insight level. This study shows that the level of EE perceived by the patients with poor insight and the person that he/she lives with, is higher than the group with good insight. The studies that investigate the relationship between the factors of insight level and EE level, which are indicated to determine the level of the illness severity and its chronicity, will enable the researchers to understand the importance of the role of the family on the treatment processes of OCD.

  13. Integrative Analyses of De Novo Mutations Provide Deeper Biological Insights into Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Atsushi Takata

    2018-01-01

    Full Text Available Recent studies have established important roles of de novo mutations (DNMs in autism spectrum disorders (ASDs. Here, we analyze DNMs in 262 ASD probands of Japanese origin and confirm the “de novo paradigm” of ASDs across ethnicities. Based on this consistency, we combine the lists of damaging DNMs in our and published ASD cohorts (total number of trios, 4,244 and perform integrative bioinformatics analyses. Besides replicating the findings of previous studies, our analyses highlight ATP-binding genes and fetal cerebellar/striatal circuits. Analysis of individual genes identified 61 genes enriched for damaging DNMs, including ten genes for which our dataset now contributes to statistical significance. Screening of compounds altering the expression of genes hit by damaging DNMs reveals a global downregulating effect of valproic acid, a known risk factor for ASDs, whereas cardiac glycosides upregulate these genes. Collectively, our integrative approach provides deeper biological and potential medical insights into ASDs.

  14. Episodic Laryngeal Breathing Disorders: Literature Review and Proposal of Preliminary Theoretical Framework.

    Science.gov (United States)

    Shembel, Adrianna C; Sandage, Mary J; Verdolini Abbott, Katherine

    2017-01-01

    The purposes of this literature review were (1) to identify and assess frameworks for clinical characterization of episodic laryngeal breathing disorders (ELBD) and their subtypes, (2) to integrate concepts from these frameworks into a novel theoretical paradigm, and (3) to provide a preliminary algorithm to classify clinical features of ELBD for future study of its clinical manifestations and underlying pathophysiological mechanisms. This is a literature review. Peer-reviewed literature from 1983 to 2015 pertaining to models for ELBD was searched using Pubmed, Ovid, Proquest, Cochrane Database of Systematic Reviews, and Google Scholar. Theoretical models for ELBD were identified, evaluated, and integrated into a novel comprehensive framework. Consensus across three salient models provided a working definition and inclusionary criteria for ELBD within the new framework. Inconsistencies and discrepancies within the models provided an analytic platform for future research. Comparison among three conceptual models-(1) Irritable larynx syndrome, (2) Dichotomous triggers, and (3) Periodic occurrence of laryngeal obstruction-showed that the models uniformly consider ELBD to involve episodic laryngeal obstruction causing dyspnea. The models differed in their description of source of dyspnea, in their inclusion of corollary behaviors, in their inclusion of other laryngeal-based behaviors (eg, cough), and types of triggers. The proposed integrated theoretical framework for ELBD provides a preliminary systematic platform for the identification of key clinical feature patterns indicative of ELBD and associated clinical subgroups. This algorithmic paradigm should evolve with better understanding of this spectrum of disorders and its underlying pathophysiological mechanisms. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  15. Cross-tissue integration of genetic and epigenetic data offers insight into autism spectrum disorder.

    Science.gov (United States)

    Andrews, Shan V; Ellis, Shannon E; Bakulski, Kelly M; Sheppard, Brooke; Croen, Lisa A; Hertz-Picciotto, Irva; Newschaffer, Craig J; Feinberg, Andrew P; Arking, Dan E; Ladd-Acosta, Christine; Fallin, M Daniele

    2017-10-24

    Integration of emerging epigenetic information with autism spectrum disorder (ASD) genetic results may elucidate functional insights not possible via either type of information in isolation. Here we use the genotype and DNA methylation (DNAm) data from cord blood and peripheral blood to identify SNPs associated with DNA methylation (meQTL lists). Additionally, we use publicly available fetal brain and lung meQTL lists to assess enrichment of ASD GWAS results for tissue-specific meQTLs. ASD-associated SNPs are enriched for fetal brain (OR = 3.55; P < 0.001) and peripheral blood meQTLs (OR = 1.58; P < 0.001). The CpG targets of ASD meQTLs across cord, blood, and brain tissues are enriched for immune-related pathways, consistent with other expression and DNAm results in ASD, and reveal pathways not implicated by genetic findings. This joint analysis of genotype and DNAm demonstrates the potential of both brain and blood-based DNAm for insights into ASD and psychiatric phenotypes more broadly.

  16. Personality and self-insight in individuals with autism spectrum disorder.

    Science.gov (United States)

    Schriber, Roberta A; Robins, Richard W; Solomon, Marjorie

    2014-01-01

    Autism spectrum disorder (ASD) involves widespread difficulties in social interaction, communication, and behavioral flexibility. Consequently, individuals with ASD are believed to exhibit a number of unique personality tendencies, including a lack of insight into those tendencies. However, surprisingly little research has examined these issues. Study 1 compared self-reports of Big Five personality traits in adults with ASD (n = 37) to those of typically developing (TD) adults (n = 42). Study 2 examined whether any observed personality differences replicated in children/adolescents with ASD (n = 50) and TD controls (n = 50) according to self- and parent reports of personality. Study 2 also assessed level of self-insight in individuals with ASD relative to TD individuals by examining the degree to which self-reports converged with parent reports in terms of self-other agreement and self-enhancement (vs. self-diminishment) biases. Individuals with ASD were more Neurotic and less Extraverted, Agreeable, Conscientious, and Open to Experience. These personality differences replicated for (a) children, adolescents, and adults; (b) self- and parent reports; and (c) males and females. However, personality traits were far from perfect predictors of ASD vs. TD group membership, did not predict within-group variability in ASD symptom severity, and had differential links to maladjustment in the ASD and TD groups, suggesting that ASD represents more than just an extreme standing on trait dimensions. Finally, individuals with ASD had a tendency to self-enhance and TD individuals, to self-diminish, but both groups showed comparable self-other agreement. Thus, individuals with ASD exhibit distinct personalities relative to TD individuals but may have a similar level of insight into them.

  17. Personality and Self-Insight in Individuals with Autism Spectrum Disorder

    Science.gov (United States)

    Schriber, Roberta A.; Robins, Richard W.; Solomon, Marjorie

    2014-01-01

    Autism spectrum disorder (ASD) involves widespread difficulties in social interaction, communication, and behavioral flexibility. Consequently, individuals with ASD are believed to exhibit a number of unique personality tendencies, including a lack of insight into them. However, surprisingly little research has examined these issues. Study 1 compared self-reports of Big Five personality traits in adults with ASD (N=37) to those of typically developing (TD) adults (N=42). Study 2 examined whether any observed personality differences replicated in children/adolescents with ASD (N=50) and TD controls (N=50) according to self- and parent reports. Study 2 also assessed level of self-insight in individuals with ASD relative to TD individuals by examining the degree to which self-reports converged with parent reports in terms of self-other agreement and self-enhancement (vs. self-diminishment) biases. Individuals with ASD were more Neurotic and less Extraverted, Agreeable, Conscientious, and Open to Experience. These personality differences replicated for (a) children, adolescents, and adults, (b) self- and parent reports, and (c) males and females. However, personality traits were far from perfect predictors of ASD vs. TD group membership, did not predict within-group variability in ASD symptom severity, and had differential links to maladjustment in the ASD and TD groups, suggesting that ASD represents more than just an extreme standing on trait dimensions. Finally, individuals with ASD had a tendency to self-enhance, and TD individuals, to self-diminish, but both groups showed comparable self-other agreement. Thus, individuals with ASD exhibit distinct personalities relative to TD individuals but may have a similar level of insight into them. PMID:24377361

  18. Gesture, Play, and Language Development of Spanish-Speaking Toddlers with Developmental Language Disorders: A Preliminary Study

    Science.gov (United States)

    Guiberson, Mark

    2016-01-01

    The purpose of this preliminary study was to (a) examine relationships between the symbolic and language skills of a mixed (developmental language disordered [DLD] and typical language [TL]) Spanish-speaking sample; (b) describe gesture, play, and language skills of DLD and TL groups; (c) compare the development between groups; and (d) explore…

  19. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders.

    Science.gov (United States)

    Lysaker, Paul H; Roe, David; Yanos, Philip T

    2007-01-01

    Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.

  20. Cognitive distortions and gambling near-misses in Internet Gaming Disorder: A preliminary study.

    Directory of Open Access Journals (Sweden)

    Yin Wu

    Full Text Available Increased cognitive distortions (i.e. biased processing of chance, probability and skill are a key psychopathological process in disordered gambling. The present study investigated state and trait aspects of cognitive distortions in 22 individuals with Internet Gaming Disorder (IGD and 22 healthy controls. Participants completed the Gambling Related Cognitions Scale as a trait measure of cognitive distortions, and played a slot machine task delivering wins, near-misses and full-misses. Ratings of pleasure ("liking" and motivation to play ("wanting" were taken following the different outcomes, and gambling persistence was measured after a mandatory phase. IGD was associated with elevated trait cognitive distortions, in particular skill-oriented cognitions. On the slot machine task, the IGD group showed increased "wanting" ratings compared with control participants, while the two groups did not differ regarding their "liking" of the game. The IGD group displayed increased persistence on the slot machine task. Near-miss outcomes did not elicit stronger motivation to play compared to full-miss outcomes overall, and there was no group difference on this measure. However, a near-miss position effect was observed, such that near-misses stopping before the payline were rated as more motivating than near-misses that stopped after the payline, and this differentiation was attenuated in the IGD group, suggesting possible counterfactual thinking deficits in this group. These data provide preliminary evidence for increased incentive motivation and cognitive distortions in IGD, at least in the context of a chance-based gambling environment.

  1. Preliminary genome-wide association study of bipolar disorder in the Japanese population.

    Science.gov (United States)

    Hattori, Eiji; Toyota, Tomoko; Ishitsuka, Yuichi; Iwayama, Yoshimi; Yamada, Kazuo; Ujike, Hiroshi; Morita, Yukitaka; Kodama, Masafumi; Nakata, Kenji; Minabe, Yoshio; Nakamura, Kazuhiko; Iwata, Yasuhide; Takei, Nori; Mori, Norio; Naitoh, Hiroshi; Yamanouchi, Yoshio; Iwata, Nakao; Ozaki, Norio; Kato, Tadafumi; Nishikawa, Toru; Kashiwa, Atsushi; Suzuki, Mika; Shioe, Kunihiko; Shinohara, Manabu; Hirano, Masami; Nanko, Shinichiro; Akahane, Akihisa; Ueno, Mikako; Kaneko, Naoshi; Watanabe, Yuichiro; Someya, Toshiyuki; Hashimoto, Kenji; Iyo, Masaomi; Itokawa, Masanari; Arai, Makoto; Nankai, Masahiro; Inada, Toshiya; Yoshida, Sumiko; Kunugi, Hiroshi; Nakamura, Michiko; Iijima, Yoshimi; Okazaki, Yuji; Higuchi, Teruhiko; Yoshikawa, Takeo

    2009-12-05

    Recent progress in genotyping technology and the development of public databases has enabled large-scale genome-wide association tests with diseases. We performed a two-stage genome-wide association study (GWAS) of bipolar disorder (BD) in Japanese cohorts. First we used Affymetrix 100K GeneChip arrays in the analysis of 107 cases with bipolar I disorder and 107 controls, and selected markers that were nominally significant (P < 0.01) in at least one of the three models (1,577 markers in total). In the follow-up stage, we analyzed these markers using an Illumina platform (1,526 markers; 51 markers were not designable for the platform) and an independent sample set, which consisted of 395 cases (bipolar I + II) and 409 controls. We also assessed the population stratification of current samples using principal components analysis. After the two-stage analysis, 89 markers remained nominally significant (allelic P < 0.05) with the same allele being consistently over-represented in both the first and the follow-up stages. However, none of these were significant after correction for multiple-testing by false discovery rates. Sample stratification was virtually negligible. Collectively, this is the first GWAS of BD in the Japanese population. But given the small sample size and the limited genomic coverage, these results should be taken as preliminary. 2009 Wiley-Liss, Inc.

  2. Cognitive distortions and gambling near-misses in Internet Gaming Disorder: A preliminary study.

    Science.gov (United States)

    Wu, Yin; Sescousse, Guillaume; Yu, Hongbo; Clark, Luke; Li, Hong

    2018-01-01

    Increased cognitive distortions (i.e. biased processing of chance, probability and skill) are a key psychopathological process in disordered gambling. The present study investigated state and trait aspects of cognitive distortions in 22 individuals with Internet Gaming Disorder (IGD) and 22 healthy controls. Participants completed the Gambling Related Cognitions Scale as a trait measure of cognitive distortions, and played a slot machine task delivering wins, near-misses and full-misses. Ratings of pleasure ("liking") and motivation to play ("wanting") were taken following the different outcomes, and gambling persistence was measured after a mandatory phase. IGD was associated with elevated trait cognitive distortions, in particular skill-oriented cognitions. On the slot machine task, the IGD group showed increased "wanting" ratings compared with control participants, while the two groups did not differ regarding their "liking" of the game. The IGD group displayed increased persistence on the slot machine task. Near-miss outcomes did not elicit stronger motivation to play compared to full-miss outcomes overall, and there was no group difference on this measure. However, a near-miss position effect was observed, such that near-misses stopping before the payline were rated as more motivating than near-misses that stopped after the payline, and this differentiation was attenuated in the IGD group, suggesting possible counterfactual thinking deficits in this group. These data provide preliminary evidence for increased incentive motivation and cognitive distortions in IGD, at least in the context of a chance-based gambling environment.

  3. Self-stigma and its relationship with insight, demoralization, and clinical outcome among people with schizophrenia spectrum disorders.

    Science.gov (United States)

    Cavelti, Marialuisa; Kvrgic, Sara; Beck, Eva-Marina; Rüsch, Nicolas; Vauth, Roland

    2012-07-01

    Paradoxically, insight is associated with positive outcomes, such as better treatment adherence and recovery, and negative outcomes, such as depression, hopelessness, low self-esteem, and quality of life. Self-stigma as a moderating variable can be decisive whether more insight leads to better or worse outcome. On the other hand, self-stigma can act as a mediator between insight and outcomes. We therefore examined self-stigma both as a moderator and a mediator. Insight, self-stigma, demoralization, symptoms, and functioning were assessed among 145 outpatients with schizophrenia spectrum disorders using questionnaires and structured interviews. Structural equation modeling was used to analyze the cross-sectional data. Results confirmed self-stigma as a moderator: The association of insight and demoralization was stronger as self-stigma increased. Self-stigma also partially mediated the positive relationship between insight and demoralization. Moreover, demoralization fully mediated the adverse associations of self-stigma with psychotic symptoms and global functioning. Given the decisive role of self-stigma regarding the detrimental consequences of insight, interventions should address self-stigma, particularly if psychoeducational or other interventions have increased insight. Therapeutic implications for changes of dysfunctional beliefs related to illness and self and change of self-concept in the context of recovery at the level of narrative identity are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Depot-medication compliance for patients with psychotic disorders: The importance of illness insight and treatment motivation

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); A.I. Wierdsma (André); P. Blanken (Peter); A.F.T. Bloemendaal (Anthony F. T.); C.L. Mulder (Niels)

    2016-01-01

    textabstractBackground: Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are

  5. Screening for Developmental Disorders in 3- and 4-Year-Old Italian Children: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Elena Catino

    2017-08-01

    Full Text Available BackgroundThe “Osserviamo” project, coordinated by the Municipality of Rome and the Department of Pediatrics and Child Neuropsychiatry of Sapienza University, aimed to validate an Italian version of the Ages and Stages Questionnaire-3 and to collect, for the first time in Italy, data on developmental disorders in a sample of 4,000 children aged 3 and 4 years. The present paper presents the preliminary results of the “Osserviamo” project.Methods600 parents of children between 39 and 50 months of age (divided in two age stages: 42 and 48 months were contacted from 15 kindergarden schools.Results23.35% of the whole sample scored in the risk range of at least one developmental area of the Ages and Stages Questionnaire-3rd Edition (ASQ-3 and 7.78% scored in the clinical range. Specifically, 23.97% of the children in the 42-month age stage scored in the risk range and 5.79% scored in the clinical range. Males scored lower than females in the fine motor skills and personal–social development domains. Moreover, 22.79% of the children in the 48-month age stage scored in the risk range, while 9.55% scored in the clinical range. Males scored lower than females in fine motor skills.ConclusionItalian validation of the ASQ-3 and recruitment of all 4,000 participants will allow these data on the distribution of developmental disorders to be extended to the general Italian pediatric population. One main limitation of the study is the lack of clinical confirmation of the data yielded by the screening programme, which the authors aim to obtain in later stages of the study.

  6. Language abilities in preschool-aged siblings of children with autism spectrum disorderspreliminary report

    Directory of Open Access Journals (Sweden)

    Ewa Pisula

    2015-01-01

    Full Text Available Background The characteristics of autism spectrum disorders (ASD observed among relatives of people affected with autism are referred to as broader autism phenotype (BAP. Among the components of BAP are language and communication skills. Research to date on these skills amongst the relatives of individuals with ASD is inconclusive. Furthermore, limited data are available about preschool-aged siblings of children with ASD. Participants and procedure Eighty-six children aged 4 years and 6 months – 6 years and 11 months took part in the study (32 girls and 54 boys. They were divided into four groups: siblings of children with autism (S/ASD, high-functioning children diagnosed with autism spectrum disorders (HF/ASD, siblings of children with Down syndrome (S/DS and siblings of typically developing children (Controls, C. Communication and language skills were tested using the Vocabulary Test for Children (TSD. It was used to assess two kinds of verbal skills: receptive language (passive and expressive language (active. Results No differences were observed in expressive lanquage or receptive language between siblings of children with ASD and siblings of children with DS as well as typically developing children. In terms of receptive language and general communication skills, siblings of children with ASD scored higher than high functioning children with ASD. High functioning children with ASD displayed difficulties with receptive language, expressive language, general language and communication skills. Conclusions The results suggest that siblings of children with ASD do not display deficits in communication and language skills. It is however important to note that due to a small sample size this study should be considered as preliminary.

  7. Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity

    Science.gov (United States)

    Müller, Hermann L.

    2016-01-01

    Purpose of review Hypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013. Recent findings Recent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams. Summary Until a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams. PMID:26574645

  8. Obsessive compulsive disorder networks: positron emission tomography and neuropsychology provide new insights.

    Directory of Open Access Journals (Sweden)

    Bruno Millet

    Full Text Available BACKGROUND: Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC in obsessive compulsive disorder (OCD. We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures. METHODS AND FINDINGS: This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level on resting-state (18FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices, the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices. CONCLUSION: As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes.

  9. Obsessive Compulsive Disorder Networks: Positron Emission Tomography and Neuropsychology Provide New Insights

    Science.gov (United States)

    Millet, Bruno; Dondaine, Thibaut; Reymann, Jean-Michel; Bourguignon, Aurélie; Naudet, Florian; Jaafari, Nematollah; Drapier, Dominique; Turmel, Valérie; Mesbah, Habiba; Vérin, Marc; Le Jeune, Florence

    2013-01-01

    Background Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC) in obsessive compulsive disorder (OCD). We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures. Methods and Findings This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level) on resting-state 18FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices), the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices. Conclusion As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes. PMID:23326403

  10. Temporomandibular disorder-type pain and migraine headache in women: a preliminary twin study.

    Science.gov (United States)

    Plesh, Octavia; Noonan, Carolyn; Buchwald, Dedra S; Goldberg, Jack; Afari, Niloo

    2012-01-01

    To determine whether shared genetic influences are responsible for the association between pain from temporomandibular disorders (TMD) and migraine headache. Data were obtained from 1,236 monozygotic and 570 dizygotic female twin pairs from the University of Washington Twin Registry. TMD pain was assessed with a question about persistent or recurrent pain in the jaw, temple, in front of the ear, or in the ear. The presence of migraine headache was determined by self-report of doctor-diagnosed migraine. Univariate and bivariate structural equation models estimated the components of variance attributable to genetic and environmental influences. The best fitting univariate models indicated that additive genetic effects contributed 27% of the variance in TMD pain (95% confidence interval = 15% to 38%) and 49% of the variance in migraine headache (95% confidence interval = 40% to 57%). The best-fitting bivariate model revealed that 12% of the genetic component of TMD pain is shared with migraine headache. These preliminary findings suggest that the association between TMD pain and migraine headache in women may be partially due to a modest shared genetic risk for both conditions. Future studies can focus on replicating these findings with symptom- and diagnosis-based instruments.

  11. Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: preliminary results.

    Science.gov (United States)

    Perroud, Nader; Nicastro, Rosetta; Jermann, Françoise; Huguelet, Philippe

    2012-09-01

    One of the components of dialectical behavior therapy (DBT) is the use of mindfulness skills as a core component of treatment for subjects with borderline personality disorder (BPD). In this study, we investigated changes in and correlates of mindfulness skills over a 1-year follow-up including a 4-week session of intensive DBT followed by 10 months of standard DBT. Fifty-two BPD subjects were assessed several times using the Kentucky Inventory of Mindfulness Skills (KIMS) which describes mindfulness in four discrete dimensions: observing (Obs), describing (Des), acting with awareness (AwA) and accepting without judgment (AwJ). AwJ was the only dimension that increased significantly over time after adjustment for potential confounding factors (β = 0.24; P = 0.0002). Increases in AwJ correlated with improvement in BPD symptoms. This study highlights the usefulness of investigating changes in mindfulness dimensions during DBT. AwJ is a possible mechanism for positive change. Encouraging this skill should lead to a more adaptive response to problematic situations and counteract impulsive and problematic behaviors. The lack of specific control groups means that these findings are preliminary and replication is required.

  12. Gratitude, abstinence, and alcohol use disorders: Report of a preliminary finding.

    Science.gov (United States)

    Krentzman, Amy R

    2017-07-01

    Gratitude is a central component of addiction recovery for many, yet it has received scant attention in addiction research. In a sample of 67 individuals entering abstinence-based alcohol-use-disorder treatment, this study employed gratitude and abstinence variables from sequential assessments (baseline, 6months, 12months) to model theorized causal relationships: gratitude would increase pre-post treatment and gratitude after treatment would predict greater percent days abstinent 6months later. Neither hypothesis was supported. This unexpected result led to the theory that gratitude for sobriety was the construct of interest; therefore, the association between gratitude and future abstinence would be positive among those already abstinent. Thus, post-treatment abstinence was tested as a moderator of the effect of gratitude on future abstinence: this effect was statistically significant. For those who were abstinent after treatment, the relationship between gratitude and future abstinence was positive; for those drinking most frequently after treatment, the relationship between gratitude and future abstinence was negative. In this preliminary study, dispositional tendency to affirm that there is much to be thankful for appeared to perpetuate the status quo-frequent drinkers with high gratitude were drinking frequently 6months later; abstinent individuals with high gratitude were abstinent 6months later. Gratitude exercises might be contraindicated for clients who are drinking frequently and have abstinence as their treatment goal. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Antonio Cerasa

    2015-01-01

    Full Text Available Presently, there are no valid biomarkers to identify individuals with eating disorders (ED. The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa were compared against 17 body mass index-matched healthy controls (HC. Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice.

  14. Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results

    Science.gov (United States)

    Cerasa, Antonio; Castiglioni, Isabella; Salvatore, Christian; Funaro, Angela; Martino, Iolanda; Alfano, Stefania; Donzuso, Giulia; Perrotta, Paolo; Gioia, Maria Cecilia; Gilardi, Maria Carla; Quattrone, Aldo

    2015-01-01

    Presently, there are no valid biomarkers to identify individuals with eating disorders (ED). The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM) technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa) were compared against 17 body mass index-matched healthy controls (HC). Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice. PMID:26648660

  15. Relationship between cognition, clinical and cognitive insight in psychotic disorders : A review and meta-analysis

    NARCIS (Netherlands)

    Nair, Akshay; Palmer, Emma Claire; Aleman, Andre; David, Anthony S.

    The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic

  16. Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

    NARCIS (Netherlands)

    de Jongh, A.; ten Broeke, E.

    2014-01-01

    Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

  17. Volume of discrete brain structures in complex dissociative disorders : preliminary findings

    NARCIS (Netherlands)

    Ehling, T.; Nijenhuis, E. R. S.; Krikke, A. P.; DeKloet, ER; Vermetten, E

    2007-01-01

    Based on findings in traumatized animals and patients with posttraumatic stress disorder, and on traumatogenic models of complex dissociative disorders, it was hypothesized that (1) patients with complex dissociative disorders have smaller volumes of hippocampus, parahippocampal gyrus, and amygdala

  18. The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders: recruitment, assessment instruments, methods for the development of multicenter collaborative studies and preliminary results.

    Science.gov (United States)

    Miguel, Euripedes Constantino; Ferrão, Ygor Arzeno; Rosário, Maria Conceição do; Mathis, Maria Alice de; Torres, Albina Rodrigues; Fontenelle, Leonardo Franklin; Hounie, Ana Gabriela; Shavitt, Roseli Gedanke; Cordioli, Aristides Volpato; Gonzalez, Christina Hojaij; Petribú, Kátia; Diniz, Juliana Belo; Malavazzi, Dante Marino; Torresan, Ricardo C; Raffin, Andréa Litvin; Meyer, Elisabeth; Braga, Daniela T; Borcato, Sonia; Valério, Carolina; Gropo, Luciana N; Prado, Helena da Silva; Perin, Eduardo Alliende; Santos, Sandro Iêgo; Copque, Helen; Borges, Manuela Corrêa; Lopes, Angélica Prazeres; Silva, Elenita D da

    2008-09-01

    To describe the recruitment of patients, assessment instruments, implementation, methods and preliminary results of The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, which includes seven university sites. This cross-sectional study included a comprehensive clinical assessment including semi-structured interviews (sociodemographic data, medical and psychiatric history, disease course and comorbid psychiatric diagnoses), and instruments to assess obsessive-compulsive (Yale-Brown Obsessive-Compulsive Scale and Dimensional Yale-Brown Obsessive-Compulsive Scale), depressive (Beck Depression Inventory) and anxious (Beck Anxiety Inventory) symptoms, sensory phenomena (Universidade de São Paulo Sensory Phenomena Scale), insight (Brown Assessment Beliefs Scale), tics (Yale Global Tics Severity Scale) and quality of life (Medical Outcome Quality of Life Scale Short-form-36 and Social Assessment Scale). The raters' training consisted of watching at least five videotaped interviews and interviewing five patients with an expert researcher before interviewing patients alone. The reliability between all leaders for the most important instruments (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale) was measured after six complete interviews. Inter-rater reliability was 96%. By March 2008, 630 obsessive-compulsive disorder patients had been systematically evaluated. Mean age (+/-SE) was 34.7 (+/-0.51), 56.3% were female, and 84.6% Caucasian. The most prevalent obsessive compulsive symptom dimensions were symmetry and contamination. The most common comorbidities were major depression, generalized anxiety and social anxiety disorder. The most common DSM-IV impulsive control disorder was skin picking. The sample was composed mainly by Caucasian individuals, unmarried, with some kind of occupational activity, mean age of 35 years, onset of obsessive

  19. Self-disorders and Schizophrenia: A Phenomenological Reappraisal of Poor Insight and Noncompliance

    OpenAIRE

    Henriksen, Mads G.; Parnas, Josef

    2013-01-01

    Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patient...

  20. Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity Among Patients With Panic Disorder: A Preliminary Study.

    Science.gov (United States)

    Ural, Cenk; Belli, Hasan; Akbudak, Mahir; Tabo, Abdulkadir

    2015-01-01

    This study assessed childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with panic disorder (PD). A total of 92 psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital, were involved in the study. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire, Panic and Agoraphobia Scale, Panic Disorder Severity Scale, and Childhood Trauma Questionnaire. Of the patients with PD, 18 (19%) had a comorbid dissociative disorder diagnosis on screening with the SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified, dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (p dissociation and PD. Among all of the subscales, the strongest relationship was with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms at admission should not lead the clinician to overlook the underlying dissociative process and associated traumatic experiences among these patients.

  1. Predicting personality disorder functioning styles by the Chinese Adjective Descriptors of Personality: a preliminary trial in healthy people and personality disorder patients.

    Science.gov (United States)

    Fan, Hongying; Zhu, Qisha; Ma, Guorong; Shen, Chanchan; Zhang, Bingren; Wang, Wei

    2016-08-30

    Cultural and personality factors might contribute to the clinical differences of psychiatric patients all over the world including China. One cultural oriented Chinese Adjective Descriptors of Personality (CADP) designed to measure normal personality traits, might be specifically associated with different personality disorder functioning styles. We therefore have invited 201 healthy volunteers and 67 personality disorder patients to undergo CADP, the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory (PVP) tests. Patients scored significantly higher on PVP scale and all 11 PERM personality disorder functioning styles, as well as CADP Emotional and Unsocial traits. The PVP was significantly correlated with some CADP traits and PERM styles in both groups. In healthy volunteers, only one CADP trait, Unsocial, prominently predicted 11 PERM styles. By contrast in patients, CADP Intelligent predicted the PERM Narcissistic and Passive-Aggressive styles; CADP Emotional the PERM Paranoid, Borderline, and Histrionic styles; CADP Conscientious the PERM Obsessive-Compulsive style; CADP Unsocial the PERM Schizotypal, Antisocial, Narcissistic, Avoidant, Dependent, and Passive-Aggressive styles; CADP Agreeable the PERM Antisocial style. As a preliminary study, our results demonstrated that, in personality disorder patients, all five CADP traits were specifically associated with almost all 11 personality disorder functioning styles, indicating that CADP might be used as an aid to diagnose personality disorders in China.

  2. Categorical and dimensional psychopathology in Dutch and US offspring of parents with bipolar disorder: A preliminary cross-national comparison.

    Science.gov (United States)

    Mesman, Esther; Birmaher, Boris B; Goldstein, Benjamin I; Goldstein, Tina; Derks, Eske M; Vleeschouwer, Marloes; Hickey, Mary Beth; Axelson, David; Monk, Kelly; Diler, Rasim; Hafeman, Danella; Sakolsky, Dara J; Reichart, Catrien G; Wals, Marjolein; Verhulst, Frank C; Nolen, Willem A; Hillegers, Manon H J

    2016-11-15

    Accumulating evidence suggests cross-national differences in adults with bipolar disorder (BD), but also in the susceptibility of their offspring (bipolar offspring). This study aims to explore and clarify cross-national variation in the prevalence of categorical and dimensional psychopathology between bipolar offspring in the US and The Netherlands. We compared levels of psychopathology in offspring of the Pittsburgh Bipolar Offspring Study (n=224) and the Dutch Bipolar Offspring Study (n=136) (age 10-18). Categorical psychopathology was ascertained through interviews using the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), dimensional psychopathology by parental reports using the Child Behavior Checklist (CBCL). Higher rates of categorical psychopathology were observed in the US versus the Dutch samples (66% versus 44%). We found no differences in the overall prevalence of mood disorders, including BD-I or -II, but more comorbidity in mood disorders in US versus Dutch offspring (80% versus 34%). The strongest predictors of categorical psychopathology were maternal BD (OR: 1.72, ppsychopathology based on CBCL reports. Preliminary measure of inter-site reliability. We found cross-national differences in prevalence of categorical diagnoses of non-mood disorders in bipolar offspring, but not in mood disorder diagnoses nor in parent-reported dimensional psychopathology. Cross-national variation was only partially explained by between-sample differences. Cultural and methodological explanations for these findings warrant further study. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Categorical and dimensional psychopathology in Dutch and US offspring of parents with bipolar disorder: A preliminary cross-national comparison✩

    Science.gov (United States)

    Mesman, Esther; Birmaher, Boris B.; Goldstein, Benjamin I.; Goldstein, Tina; Derks, Eske M.; Vleeschouwer, Marloes; Hickey, Mary Beth; Axelson, David; Monk, Kelly; Diler, Rasim; Hafeman, Danella; Sakolsky, Dara J.; Reichart, Catrien G.; Wals, Marjolein; Verhulst, Frank C.; Nolen, Willem A.; Hillegers, Manon H.J.

    2017-01-01

    Objective Accumulating evidence suggests cross-national differences in adults with bipolar disorder (BD), but also in the susceptibility of their offspring (bipolar offspring). This study aims to explore and clarify cross-national variation in the prevalence of categorical and dimensional psychopathology between bipolar offspring in the US and The Netherlands. Methods We compared levels of psychopathology in offspring of the Pittsburgh Bipolar Offspring Study (n=224) and the Dutch Bipolar Offspring Study (n=136) (age 10–18). Categorical psychopathology was ascertained through interviews using the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), dimensional psychopathology by parental reports using the Child Behavior Checklist (CBCL). Results Higher rates of categorical psychopathology were observed in the US versus the Dutch samples (66% versus 44%). We found no differences in the overall prevalence of mood disorders, including BD-I or -II, but more comorbidity in mood disorders in US versus Dutch offspring (80% versus 34%). The strongest predictors of categorical psychopathology were maternal BD (OR: 1.72, ppsychopathology based on CBCL reports. Limitations Preliminary measure of inter-site reliability. Conclusions We found cross-national differences in prevalence of categorical diagnoses of non-mood disorders in bipolar offspring, but not in mood disorder diagnoses nor in parent-reported dimensional psychopathology. Cross-national variation was only partially explained by between-sample differences. Cultural and methodological explanations for these findings warrant further study. PMID:27423424

  4. Association between prefrontal N-acetylaspartate and insight in psychotic disorders

    NARCIS (Netherlands)

    Larabi, Daouia I.; Liemburg, Edith; Pijnenborg, Gerdina H.M. Pijnenborg; Sibeijn-Kuiper, Anita; de Vos, Annerieke E.; Bais, Leonie; Knegtering, Henderikus; Curcic-Blake, Branisalava; Aleman, Andre

    Insight is impaired in most patients with psychosis and has been associated with poorer prognosis. The exact neural basis of impaired insight is still unknown, but it may involve disrupted prefrontal neural connectivity. Numerous studies have indeed found white matter (WM) abnormalities in

  5. Changes in insight during treatment for psychotic disorders : A meta-analysis

    NARCIS (Netherlands)

    Pijnenborg, Gerdina H. M.; van Donkersgoed, Rozanne J. M.; David, Anthony S.; Aleman, Andre

    Objective: Poor insight, or awareness of illness, has a negative impact on the outcome of the psychosis, and is therefore a logical target for treatment. A meta-analysis of the effect of psychological and pharmacological treatments on insight in psychosis was conducted to give a comprehensive

  6. Personality disorder functioning styles are associated with the effects of the cognitive-behavioral therapy for panic disorder: a preliminary study.

    Science.gov (United States)

    Chen, Wanzhen; Hu, Jing; Xu, Shaofang; Shen, Mowei; Chai, Hao; Wang, Wei

    2014-06-01

    The effect of the cognitive behavioral therapy (CBT) for panic disorder varies, but how personality disorder functioning style influences it remains unclear. In 30 healthy volunteers and 44 patients with panic disorder (22 treated and 22 waiting list), we administered the Parker Personality Measure (PERM) and the Plutchik-van Praag Depression Inventory (PVP). Before and during the CBT or waiting period, patients were asked to record their panic attacks using the Panic Attack Record (PAR). Patients scored significantly higher on PERM Antisocial, Borderline, Histrionic, Avoident, Dependent, and Passive-aggressive styles and on depression. After CBT, all PAR parameters were significantly reduced in the treated group. The Obsessive-compulsive style was positively correlated with the panic attack duration and the total-thought before CBT or waiting period in all patients. In treated patients, the decreased panic attack duration was positively correlated with Histrionic, Obsessive-compulsive and Passive-aggressive; the decreased total symptom number was positively correlated with Antisocial and Histrionic; the decreased total-sensation was positively correlated with antisocial; and the total-thought was positively correlated with Narcissistic style. The length and duration of CBT was short and mainly with behavioral strategies, how personality influenced the related cognition per se remains unknown here. However, our preliminary results indicate that personality disorder functioning styles related to the externalized behaviors and the Obsessive-compulsive style have positive effects on CBT for panic disorder, implying that CBT practitioners should note their personality styles when treating these patients.

  7. Association between prefrontal N-acetylaspartate and insight in psychotic disorders.

    Science.gov (United States)

    Larabi, Daouia I; Liemburg, Edith J; Pijnenborg, Gerdina H M; Sibeijn-Kuiper, Anita; de Vos, Annerieke E; Bais, Leonie; Knegtering, Henderikus; Ćurčić-Blake, Branislava; Aleman, André

    2017-01-01

    Insight is impaired in most patients with psychosis and has been associated with poorer prognosis. The exact neural basis of impaired insight is still unknown, but it may involve disrupted prefrontal neural connectivity. Numerous studies have indeed found white matter (WM) abnormalities in psychosis. The association between prefrontal WM abnormalities and insight has not been studied yet by means of proton magnetic resonance spectroscopy ( 1 H-MRS). 1 H-MRS can be used to measure N-acetylaspartate (NAA), which is considered to be a marker of neuronal integrity. We measured insight with the Birchwood Insight Scale (BIS) as well as item G12 of the Positive and Negative Syndrome Scale (PANSS) in 88 patients with psychosis. Prefrontal WM concentrations of NAA and ratios of NAA to creatine (Cr) were assessed with 1 H-MRS. Nonparametric partial correlational analyses were conducted between NAA concentrations and insight controlling for illness duration, standardized antipsychotic dose, symptom scores, voxel grey matter content and voxel cerebrospinal fluid content. We found a significant correlation between reduced NAA/Cr ratios and poorer insight as measured with the BIS, which remained significant after additional correction for full width at half maximum, signal/noise and age. This is the first study reporting a relationship between lower prefrontal concentrations of a marker of neuronal integrity and impaired insight, providing further evidence that prefrontal pathology may play an important role in impaired insight in psychosis. This may be explained by the involvement of the prefrontal cortex in several executive and metacognitive functions, such as cognitive flexibility and perspective taking. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Preliminary Evaluation of Outcomes of Transactional Analysis Psychotherapy for Armed Forces Veterans presenting with Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    David Harford

    2013-07-01

    Full Text Available This brief outline presents some initial findings from a pilot project conducted within a charity settingin the UK, examining clinical outcomes for a cohort of armed forces veterans presenting with post-traumatic stress disorder (PTSD. Outcomes were measuredusing CORE-OM (Evans et al 2000, PHQ-9 (Kroenke et al 2001 and GAD-7 (Spitzer et al 2006. Preliminary findings show that positive Reliable Change on global distress and anxiety had taken place within 16 sessions. These results suggest that transactional analysis psychotherapy has promise for treatment of PTSD with this client group and that further research is warranted.

  9. Influence of inter-stimulus interval of spinal cord stimulation in patients with disorders of consciousness: A preliminary functional near-infrared spectroscopy study.

    Science.gov (United States)

    Zhang, Yujin; Yang, Yi; Si, Juanning; Xia, Xiaoyu; He, Jianghong; Jiang, Tianzi

    2018-01-01

    Spinal cord stimulation (SCS) is a promising treatment for disorders of consciousness (DOC), but the underlying mechanism and most effective procedures remain uncertain. To optimize the protocol, previous studies evaluated the frequency-specific effects of SCS on neurophysiological activities. However, whether and how the inter-stimulus interval (ISI) parameter affects the SCS neuromodulation in DOC remains unknown. We enrolled nine DOC patients who had implanted SCS devices and conducted three different durations of ISIs. Using functional near-infrared spectroscopy (fNIRS), we monitored the blood volume fluctuations in the prefrontal and occipital cortices during the SCS. The results showed that short stimuli (30 s) induced significant cerebral blood volume changes, especially in the prefrontal cortex, an important area in the consciousness system. By comparing the mean value of the responses from the first and the last block in each session, a shorter ISI was found to improve the blood volume in the prefrontal cortex. This phenomenon was more significant for the subgroup of patients with a favorable prognosis. These preliminary results imply that the ISI may be an important factor for SCS. The research paradigm proposed here also provides insights for further quantitative evaluations of the therapeutic effects of neuromodulation.

  10. A Preliminary Investigation of the Long-Term Outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

    Science.gov (United States)

    Bullis, Jacqueline R.; Fortune, Meghan R.; Farchione, Todd J.; Barlow, David H.

    2014-01-01

    Objective To conduct a preliminary examination of long-term outcomes on a broad range of affective disorder symptoms treated with a newly developed intervention: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). Method Maintenance of treatment gains at long-term follow-up (LTFU) were explored in patients (n = 15, mean age = 32.27; 60% female) who completed a clinical trial of the UP. Results Treatment gains observed at 6-month follow-up (6MFU) on measures of clinical severity, general symptoms of depression and anxiety, and a measure of symptom interference in daily functioning were largely maintained 12 months later (at an average of 18 months posttreatment), and any significant changes from 6MFU to LTFU reflected small increases in symptoms that remained, on average, in the subclinical range. Conclusions These findings provide the first initial support for the durability of broad treatment gains following transdiagnostic treatment. PMID:25113056

  11. Insights Into Aspects Behind Internet-Related Disorders in Adolescents: The Interplay of Personality and Symptoms of Adjustment Disorders.

    Science.gov (United States)

    Müller, Kai W; Wölfling, Klaus; Beutel, Manfred E; Stark, Birgit; Quiring, Oliver; Aufenanger, Stefan; Schemer, Christian; Weber, Mathias; Reinecke, Leonard

    2018-02-01

    Problematic Internet use (PIU) that has recently been referred to as Internet-related disorder is a growing health concern. Yet, it is unclear why some adolescents are developing problematic use, whereas others sustain control. Based on previous research, we hypothesize that personality traits (low conscientiousness and high neuroticism) act as predispositions for PIU. We further hypothesize that PIU can be understood as a maladaptive reaction toward critical life events and that these maladaptive reactions are exacerbated by dysfunctional personality traits. The study investigates the prevalence of distinct subtypes of PIU among a sample of adolescents (n = 1,489; 10-17 years). Personality traits (Big Five Inventory-10 [BFI-10]), perceived stress (Perceived Stress Scale 4 [PSS-4]), and their relations to PIU (Scale for the Assessment of Internet and Computer Game Addiction [AICA-S]) were examined. As novel research questions, associations between PIU and adjustment disorders (Adjustment Disorder-New Module [ADNM]-6) and the mediating role of personality were investigated. The prevalence of PIU was 2.5%; girls (3.0%) were more often affected than boys (1.9%). Social networking sites in girls and online games in boys were most often associated with PIU. Low conscientiousness and high neuroticism generally predicted PIU. Significantly more adolescents with PIU (70%) reported critical life events compared with those without PIU (42%). PIU was related to heightened stress and higher adjustment disorder symptoms. These associations were exacerbated by conscientiousness and neuroticism. Although the overall prevalence for PIU is in line with previous studies, it appeared unexpectedly that girls were affected more often than boys. Adjustment disorders and stress showed strong associations with PIU. This bears implications for adapting etiopathological assumptions and early intervention strategies. Copyright © 2017 The Society for Adolescent Health and Medicine

  12. Molecular underpinnings of prefrontal cortex development in rodents provide insights into the etiology of neurodevelopmental disorders.

    Science.gov (United States)

    Schubert, D; Martens, G J M; Kolk, S M

    2015-07-01

    The prefrontal cortex (PFC), seat of the highest-order cognitive functions, constitutes a conglomerate of highly specialized brain areas and has been implicated to have a role in the onset and installation of various neurodevelopmental disorders. The development of a properly functioning PFC is directed by transcription factors, guidance cues and other regulatory molecules and requires the intricate and temporal orchestration of a number of developmental processes. Disturbance or failure of any of these processes causing neurodevelopmental abnormalities within the PFC may contribute to several of the cognitive deficits seen in patients with neurodevelopmental disorders. In this review, we elaborate on the specific processes underlying prefrontal development, such as induction and patterning of the prefrontal area, proliferation, migration and axonal guidance of medial prefrontal progenitors, and their eventual efferent and afferent connections. We furthermore integrate for the first time the available knowledge from genome-wide studies that have revealed genes linked to neurodevelopmental disorders with experimental molecular evidence in rodents. The integrated data suggest that the pathogenic variants in the neurodevelopmental disorder-associated genes induce prefrontal cytoarchitectonical impairments. This enhances our understanding of the molecular mechanisms of prefrontal (mis)development underlying the four major neurodevelopmental disorders in humans, that is, intellectual disability, autism spectrum disorders, attention deficit hyperactivity disorder and schizophrenia, and may thus provide clues for the development of novel therapies.

  13. The neuropsychiatry of hyperkinetic movement disorders: insights from neuroimaging into the neural circuit bases of dysfunction.

    Science.gov (United States)

    Hayhow, Bradleigh D; Hassan, Islam; Looi, Jeffrey C L; Gaillard, Francesco; Velakoulis, Dennis; Walterfang, Mark

    2013-01-01

    Movement disorders, particularly those associated with basal ganglia disease, have a high rate of comorbid neuropsychiatric illness. We consider the pathophysiological basis of the comorbidity between movement disorders and neuropsychiatric illness by 1) reviewing the epidemiology of neuropsychiatric illness in a range of hyperkinetic movement disorders, and 2) correlating findings to evidence from studies that have utilized modern neuroimaging techniques to investigate these disorders. In addition to diseases classically associated with basal ganglia pathology, such as Huntington disease, Wilson disease, the neuroacanthocytoses, and diseases of brain iron accumulation, we include diseases associated with pathology of subcortical white matter tracts, brain stem nuclei, and the cerebellum, such as metachromatic leukodystrophy, dentatorubropallidoluysian atrophy, and the spinocerebellar ataxias. Neuropsychiatric symptoms are integral to a thorough phenomenological account of hyperkinetic movement disorders. Drawing on modern theories of cortico-subcortical circuits, we argue that these disorders can be conceptualized as disorders of complex subcortical networks with distinct functional architectures. Damage to any component of these complex information-processing networks can have variable and often profound consequences for the function of more remote neural structures, creating a diverse but nonetheless rational pattern of clinical symptomatology.

  14. Correlation Between Insight and Capacity to Consent to Research in Subjects With Bipolar Disorder Type I and Schizophrenia.

    Science.gov (United States)

    López-Jaramillo, Carlos; Tobler, Chantal Aristizábal; Gómez, Constanza Ovalle; Triana, Jaime Escobar

    2016-01-01

    Schizophrenia and bipolar disorder type I (BD-I) can affect patient autonomy and capacity to consent to participate in research. Other variables associated with the autonomy of patients must be explored in order to improve the quality of the currently available tools. To evaluate the relationship between insight and the capacity to consent to participate in research in patients with BD-I and schizophrenia. A cross-sectional and longitudinal study was conducted with 120 subjects (40 subjects with schizophrenia, 40 with BD-I, and 40 healthy controls). The tools used were the Scale Assessment Insight-Expanded (SAI-E) and the MacArthur Competence Assessment Tool-Treatment (MacCAT-CR), which was first adapted culturally, and its validity and reliability assessed. The results obtained on each scale were compared and the association between them were evaluated. There is a direct correlation between the capacity to consent to research, measured using the MacCAT-CR tool, and the degree of insight, measured using the SAI-E scale, with an effect size of 1.3 for BD-I and 2.03 for schizophrenia. The results suggest that there is a correlation between the degree of insight and the capacity to consent to research in subjects with schizophrenia and BD-I. Insight should therefore be included as a relevant variable to assess the capacity to consent, and future studies should include it when researching on or designing new tools which aim at a greater respect of patient autonomy. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. How self-reflection and self-certainty are related to neurocognitive functioning: an examination of cognitive insight in bipolar disorder.

    Science.gov (United States)

    Van Camp, L S C; Oldenburg, J F E; Sabbe, B G C

    2016-01-01

    The pattern of associations between clinical insight, cognitive insight, and neurocognitive functioning was assessed in bipolar disorder patients. Data from 42 bipolar disorder patients were examined. Cognitive insight was measured using the Beck Cognitive Insight Scale (BCIS). The BCIS is a 15-item self-report instrument consisting of two subscales, self-reflectiveness and self-certainty. Clinical insight was measured by the use of the item G12 of the Positive and Negative Syndrome Scale. Neurocognitive functioning was assessed using the International Society for Bipolar Disorders-Battery for Assessment of Neurocognition. Correlation analyses revealed significant positive associations between self-reflectiveness and speed of processing, attention, working memory, visual learning, and reasoning and problem solving. The subscale self-certainty was negatively correlated to working memory, however, this correlation disappeared when we controlled for confounding variables. No correlations between clinical insight and neurocognition were found. In addition, there was no association between cognitive insight and clinical insight. Better neurocognitive functioning was more related to higher levels of self-reflectiveness than to diminished self-certainty.

  16. Functional magnetic resonance imaging in disorders of consciousness: preliminary results of an innovative analysis of brain connectivity.

    Science.gov (United States)

    De Pasquale, Francesco; Caravasso, Chiara Falletta; Péran, Patrice; Catani, Sheila; Tuovinen, Noora; Sabatini, Umberto; Formisano, Rita

    2015-01-01

    The aim of this preliminary study was to present a new approach for connectivity analysis in patients with severe acquired brain injury (ABI) that overcomes some of the difficulties created by anatomical abnormalities due to the brain injury. Using a data-driven approach, resting-state structural MRI (sMRI) and functional MRI (fMRI) data from three severe ABI patients - two with disorders of consciousness (DOC) and one who had recovered consciousness (non-DOC) - were integrated and analyzed. Parameters extracted from the distribution of the connectivity values, such as mean, standard deviation and skeweness, were considered. The distribution parameters estimated seem to provide an accurate multivariate classification of the considered cases that can be summarized as follows: connectivity in the severe ABI patients with DOC was on average lower than in the severe ABI non-DOC patient and healthy subjects. The dispersion of connectivity values of the severe ABI patients, non-DOC and DOC, was comparable, however the shape of the distribution was different in the non-DOC patient. Eventually, seed-based connectivity maps of the default mode Functional magnetic resonance imaging in disorders of consciousness: preliminary results of an innovative analysis of brain connectivity network show a pattern of increasing disruption of this network from the healthy subjects to non-DOC and DOC patients. Consistent results are obtained using an ICA-based approach..

  17. A Preliminary Study of D-Cycloserine Augmentation of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.; Lewin, Adam B.; Henin, Aude; Micco, Jamie A.; Sprich, Susan; Wilhelm, Sabine; Bengtson, Michael; Geller, Daniel A.

    2010-01-01

    Background Research on the neural circuitry underlying fear extinction has led to the examination of d-cycloserine (DCS), a partial agonist at the NMDA receptor in the amygdala, as a method of enhancing exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine if weight-adjusted DCS doses (25 or 50mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Method Participants were 30 youth (ages 8–17) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT+DCS versus CBT+Placebo (15 youth per group). All patients received 7 E/RP sessions paired with DCS or placebo taken 1 hour prior to sessions. Results Although not significantly different, compared to the CBT+Placebo group, youth in the CBT+DCS arm showed small-to-moderate treatment effects (d=.31 to .47 on primary outcomes). No adverse events were recorded. Conclusions The present results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD. PMID:20817153

  18. Mental disorders as networks of problems : A review of recent insights

    NARCIS (Netherlands)

    Fried, Eiko I.; van Borkulo, Claudia D.; Cramer, Angelique O. J.; Boschloo, Lynn; Schoevers, Robert A.; Borsboom, Denny

    The network perspective on psychopathology understands mental disorders as complex networks of interacting symptoms. Despite its recent debut, with conceptual foundations in 2008 and empirical foundations in 2010, the framework has received considerable attention and recognition in the last years.

  19. Preliminary data on the prevalence of psychiatric disorders in Brazilian male and female juvenile delinquents

    Directory of Open Access Journals (Sweden)

    Andrade R.C.

    2004-01-01

    Full Text Available The aim of the present investigation was to study the prevalence of psychiatric disorders in a sample of delinquent adolescents of both genders and to compare the prevalence between genders. A total of 116 adolescents (99 males and 17 females aged 12 to 19 on parole in the State of Rio de Janeiro were interviewed using the screening interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime (KSADS-PL. Data were collected between May 2002 and January 2003. Of 373 male and 58 female adolescents present in May 2002 in the largest institution that gives assistance to adolescents on parole in the city of Rio de Janeiro, 119 subjects were assessed (three of them refused to participate. Their average age was 16.5 years with no difference between genders. The screening interview was positive for psychopathology for most of the sample, with the frequencies of the suggested more prevalent psychiatric disorders being 54% for attention-deficit/hyperactivity disorder, 77% for conduct disorder, 41% for oppositional defiant disorder, 57% for anxiety disorder 57, 60% for depressive disorder 60, 63% for illicit drug abuse, and 58% for regular alcohol use. Internalizing disorders (depressive disorders, anxiety disorders and phobias were more prevalent in the female subsample. There was no significant difference in the prevalence of illicit drug abuse between genders. There were more male than female adolescents on parole and failure to comply with the sentence was significantly more frequent in females. The high prevalence of psychopathology suggested by this study indicates the need for psychiatric treatment as part of the prevention of juvenile delinquency or as part of the sentence. However, treatment had never been available for 93% of the sample in this study.

  20. Preliminary study of relationships between hypnotic susceptibility and personality disorder functioning styles in healthy volunteers and personality disorder patients

    Directory of Open Access Journals (Sweden)

    He Wei

    2011-07-01

    Full Text Available Abstract Background Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered. Methods In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC and the Parker Personality Measure (PERM tests. Results Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β = 0.26 and Anosmia to Ammonia (β = -0.23 were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β = 0.25 but negatively the PERM Narcissistic style (β = -0.23. Conclusions Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions.

  1. Wittgenstein's philosophy and a dimensional approach to the classification of mental disorders -- a preliminary scheme.

    Science.gov (United States)

    Mackinejad, Kioumars; Sharifi, Vandad

    2006-01-01

    In this paper the importance of Wittgenstein's philosophical ideas for the justification of a dimensional approach to the classification of mental disorders is discussed. Some of his basic concepts in his Philosophical Investigations, such as 'family resemblances', 'grammar' and 'language-game' and their relations to the concept of mental disorder are explored.

  2. Development of Anxiety Disorders in a Traumatized Pediatric Population: A Preliminary Longitudinal Evaluation

    Science.gov (United States)

    Cortes, Adriana M.; Saltzman, Kassey M.; Weems, Carl F.; Regnault, Heather P.; Reiss, Allan L.; Carrion, Victor G.

    2005-01-01

    Objective: The current study was conducted to determine if post-traumatic stress disorder (PTSD) symptomatology predicted later development of non-PTSD anxiety disorders in children and adolescents victimized by interpersonal trauma. Methods: Thirty-four children with a history of interpersonal trauma and no initial diagnosis of anxiety disorder…

  3. Supported Employment for Young Adults with Autism Spectrum Disorder: Preliminary Data

    Science.gov (United States)

    Wehman, Paul; Lau, Stephanie; Molinelli, Alissa; Brooke, Valerie; Thompson, Katie; Moore, Chandler; West, Michael

    2012-01-01

    The purpose of this study was to examine the effects of supported employment in securing and maintaining competitive employment for people with autism spectrum disorder, a group that has typically been found to be underemployed or unemployed. This prospective study followed and collected data on 33 individuals with autism spectrum disorder as they…

  4. Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

    Directory of Open Access Journals (Sweden)

    Ernika G. Quimby

    2012-08-01

    Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.

  5. Temperamental correlates of disruptive behavior disorders in young children: preliminary findings.

    Science.gov (United States)

    Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V; Violette, Heather; Wrightsman, Jessica; Rosenbaum, Jerrold F

    2002-04-01

    Our objective was to test the hypothesis that temperamental behavioral disinhibition measured in early childhood would be associated with disruptive behavior disorders. We used variables from laboratory-based behavioral observations originally devised to assess behavioral inhibition to construct a theory-based a priori definition of "behavioral disinhibition" in 200 young children at-risk for panic disorder, depression, or both and 84 children of parents without anxiety or major depressive disorder. We then compared behaviorally disinhibited and nonbehaviorally disinhibited children on rates of DSM-III-R disorders and measures of academic and social dysfunction. Behavioral disinhibition was significantly associated with higher rates of disruptive behavior disorders and mood disorders. Children with behavioral disinhibition were significantly more likely than nondisinhibited, noninhibited children to have attention-deficit/hyperactivity disorder (ADHD) and to have comorbid mood and disruptive behavior disorders. Moreover, disinhibited children had lower Global Assessment of Functioning Scale scores and were more likely to have been in special classes and to have problems with school behavior and leisure activities. These results suggest that behavioral disinhibition may represent a temperamental precursor to disruptive behavior problems, particularly ADHD. Longitudinal studies using behavioral assessments of behavioral disinhibition are needed to confirm these findings.

  6. HPA-axis hyperactivity and mortality in psychotic depressive disorder: preliminary findings.

    Science.gov (United States)

    Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark; Young, Elizabeth

    2008-06-01

    The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder. The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m. Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to CV causes (t=4.01, pdepressive disorder to CV mortality.

  7. High-dose vitamin B6 decreases homocysteine serum levels in patients with schizophrenia and schizoaffective disorders: a preliminary study.

    Science.gov (United States)

    Miodownik, Chanoch; Lerner, Vladimir; Vishne, Tali; Sela, Ben-Ami; Levine, Joseph

    2007-01-01

    Vitamin B6 plays an essential role in the normal functioning of the central nervous system. Normal homocysteine (Hcy) serum level is maintained by remethylation of Hcy to methionine by enzymes that require folic acid and vitamin B12 and by catabolism to cysteine by a vitamin B6-dependent enzyme. These findings may be consistent with the hypothesis that the vitamin B6 status may influence plasma Hcy levels. The aims of this preliminary study were (1) to determine whether a correlation exists between Hcy and vitamin B6 levels in patients with schizophrenia and schizoaffective disorders and (2) to investigate whether treatment with high-dose vitamin B6 may reduce Hcy levels in these patients. In this preliminary study, we enrolled 11 patients with schizophrenia or schizoaffective disorders (7 men and 4 women; mean age +/- SD, 50 +/- 12 years) receiving high doses of vitamin B6 treatment (1200 mg/d) for 12 weeks. Blood samples for the assessment of pyridoxal-5-phosphate and Hcy serum levels were obtained at baseline and after 12 weeks of treatment. Age was significantly positively correlated with Hcy levels at baseline (r = 0.392, P = 0.004). All other parameters, including diagnosis, disease duration, and pyridoxal-5-phosphate serum level, were not correlated with Hcy serum levels at baseline. After vitamin B6 treatment, Hcy serum levels significantly decreased (14.2 +/- 3.4 vs. 11.8 +/- 2.0 micromol/L, respectively, t = 2.679, P = 0.023); this decrease being statistically significant in men but not in women. High doses of vitamin B6 lead to a decrease in Hcy serum level in male patients with schizophrenia or schizoaffective disorder.

  8. Animal Models of Post-Traumatic Stress Disorder and Recent Neurobiological Insights

    Science.gov (United States)

    Whitaker, Annie M.; Gilpin, Nicholas W.; Edwards, Scott

    2014-01-01

    Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to develop PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress- and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often observed combination of PTSD and co-morbid conditions such as alcohol use disorder (AUD). Future studies will continue to refine preclinical PTSD models in hopes of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders. PMID:25083568

  9. Knowledge and insight in relation to functional remission in patients with long-term psychotic disorders

    DEFF Research Database (Denmark)

    Alenius, Malin; Hammarlund-Udenaes, Margareta; Hartvig, Per

    2009-01-01

    : To investigate the knowledge and insight in relation to treatment response. METHODS: A naturalistic study was performed using patient interviews and information gathered from patient drug charts. Apart from the rating scales used for classification of treatment response (CANSEPT method), the SPKS knowledge......BACKGROUND: Patients with psychotic symptoms often respond poorly to treatment. Outcomes can be affected by biological, physiological and psychological factors according to the vulnerability-stress model. The patient's coping strategies and beliefs have been correlated with outcomes. OBJECTIVES...... of illness and drugs rating scale was utilized. RESULTS: In the group of patients in functional remission (FR; n = 38), 37% had insight into their illness as compared to 10% among those not in functional remission (non-FR; n = 78; P strategy for responding...

  10. Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study.

    Science.gov (United States)

    Byatt, Nancy; Cox, Lucille; Moore Simas, Tiffany A; Biebel, Kathleen; Sankaran, Padma; Swartz, Holly A; Weinreb, Linda

    2018-03-01

    Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.

  11. Gait unsteadiness and fall risk in two affective disorders: a preliminary study

    Directory of Open Access Journals (Sweden)

    Peng Chung-Kang

    2004-11-01

    Full Text Available Abstract Background In older adults, depression has been associated with increased fall risk, but the reasons for this link are not fully clear. Given parallels between major depression and Parkinson's disease, we hypothesized that major depression and related affective disorders would be associated with impairment in the ability to regulate the stride-to-stride fluctuations in gait cycle timing. Methods We measured stride-to-stride fluctuations of patients with two forms of mood disorders, unipolar major depressive disorder (MDD and bipolar disorder, and compared their gait to that of a healthy control group. The primary outcomes were two measures of gait unsteadiness that have been associated with fall risk: stride time variability and swing time variability. Results Compared to the control group, the two patient groups tended to walk more slowly and with decreased swing time and increased stride time. However, none of these differences was statistically significant. Compared to the control group, swing time variability was significantly larger in the subjects with bipolar disorder (p Conclusions Patients with MDD and patients with bipolar disorder display gait unsteadiness. This perturbation in gait may provide a mechanistic link connecting depression and falls. The present findings also suggest the possibility that measurement of variability of gait may provide a readily quantifiable objective approach to monitoring depression and related affective disorders.

  12. Internet-Based Self-Help Intervention for ICD-11 Adjustment Disorder: Preliminary Findings.

    Science.gov (United States)

    Eimontas, Jonas; Rimsaite, Zivile; Gegieckaite, Goda; Zelviene, Paulina; Kazlauskas, Evaldas

    2018-06-01

    Adjustment disorder is one of the most diagnosed mental disorders. However, there is a lack of studies of specialized internet-based psychosocial interventions for adjustment disorder. We aimed to analyze the outcomes of an internet-based unguided self-help psychosocial intervention BADI for adjustment disorder in a two armed randomized controlled trial with a waiting list control group. In total 284 adult participants were randomized in this study. We measured adjustment disorder as a primary outcome, and psychological well-being as a secondary outcome at pre-intervention (T1) and one month after the intervention (T2). We found medium effect size of the intervention for the completer sample on adjustment disorder symptoms. Intervention was effective for those participants who used it at least one time in 30-day period. Our results revealed the potential of unguided internet-based self-help intervention for adjustment disorder. However, high dropout rates in the study limits the generalization of the outcomes of the intervention only to completers.

  13. Active reward processing during human sleep: insights from sleep-related eating disorder

    Directory of Open Access Journals (Sweden)

    Lampros ePerogamvros

    2012-11-01

    Full Text Available In this paper, we present two carefully documented cases of patients with sleep-related eating disorder (SRED, a parasomnia which is characterized by involuntary compulsive eating during the night and whose pathophysiology is not known. Using video-polysomnography and psychometric examination, we found that both patients present elevated novelty seeking and increased reward sensitivity on reward-related questionnaires. In light of new evidence on the mesolimbic dopaminergic implication in compulsive eating disorders, our findings suggest a role of an active reward system during sleep in the manifestation of SRED.

  14. In the swim of things: recent insights to neurogenetic disorders from zebrafish.

    Science.gov (United States)

    Kabashi, Edor; Champagne, Nathalie; Brustein, Edna; Drapeau, Pierre

    2010-08-01

    The advantage of zebrafish as a model to study human pathologies lies in the ease of manipulating gene expression in vivo. Here we focus on recent progress in our understanding of motor neuron diseases and neurodevelopmental disorders and discuss how novel technologies will permit further disease models to be developed. Together these advances set the stage for this simple functional model, with particular advantages for transgenesis, multigenic analyses and chemical biology, to become uniquely suited for advancing the functional genomics of neurological and possibly psychiatric diseases - from understanding the genetics and cell biology of degenerative and developmental disorders to the discovery of therapeutics. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. Insights from the correlation of the preliminary Geologic and Mineralogic maps of Vesta from the Dawn mission data

    Science.gov (United States)

    Frigeri, A.; De Sanctis, M. C.; Ammannito, E.; Yingst, R. A.; Mest, S.; Garry, B.; Magni, G.; Palomba, E.; Petro, N.; Tosi, F.; Williams, D.; Zambon, F.; Jaumann, R.; Pieters, C. M.; Raymond, C. A.; Russell, C. T.

    2012-04-01

    The Dawn mission to Vesta has greatly improved the quality and resolution of data available to explore the asteroid. Prior to the Dawn mission the best data available was the one from Hubble Space Telescope with a maximum resolution of 50 km per pixel. The survey phase of the mission has pushed spatial resolution up to about 100 meters per pixel by the Framing Camera on-board Dawn, and 700 meters per pixel for the VIR spectrometer, spanning the spectral range from the visible to infrared at 0.25-1 μm and 1-5 μm. The frames of the FC and VIR have been processed and mosaicked. A preliminary Geologic map has been produced by mapping units and structures over the FC mosaic and the DTM derived from stereo processing of visible imagery. We will present some examples of correlation between the preliminary geologic and VIR-derived mineralogic maps. The Dawn mission team is using Geographic Information System tools for locating frames and for data exchange among the team. The use of GIS tools and data formats significantly improves our ability to create and interpret geologic maps, and also improves the interoperability of high level data products among the instruments' team. VIR data have been synthesized into a series of spectral indicators that give indications on the mineralogical composition and the physical state of the surface. We ingested in GIS the the preliminary geologic map as units and structures and we projected the mosaics of spectral indicators in a common coordinate reference system. The first spectral indicators we started to look at were the Band Depth computed on pyroxene Band II and the Band Center also computed on Band II. The comparison of the preliminary geologic map and the mosaics of spectral indicators extracted from VIR data show promising aspects on both the geologic and mineralogic aspects. Geologic units are made up of bodies of rock that are interpreted to have been formed by a particular process or set of related processes over a discrete

  16. Association of Tourette syndrome and obsessive-compulsive disorder with allergic diseases in children and adolescents: a preliminary study.

    Science.gov (United States)

    Yuce, M; Guner, S N; Karabekiroglu, K; Baykal, S; Kilic, M; Sancak, R; Karabekiroglu, A

    2014-01-01

    To investigate the rate of allergic diseases including asthma, allergic rhinitis and eczema in children and adolescents diagnosed with obsessive-compulsive disorder (OCD) (n:26) and/or Tourette syndrome (TS) (n:32) [OCD plus TS, n:13] compared to control subjects (n:35) [total, n:80]. The symptoms of any allergic disease were assessed using the ISAAC questionnaire form. Allergy diagnoses were made by a pediatric allergy specialist. Skin prick tests were applied, and IgE levels and eosinophil counts were measured. While only one-fifth of the control subjects had allergic diseases, more than half of the children with TS and/or OCD had comorbid allergic diseases. Positive skin prick tests were greater in OCD patients compared to control subjects. There were no significant differences between the groups in terms of eosinophil counts or IgE levels. Among the allergic diseases, while allergic rhinitis was diagnosed at significantly higher rates in TS patients, eczema was significantly higher in OCD patients compared to control subjects. This preliminary study shows an association between allergic diseases and TS and/or OCD. The results revealing differences in associations between types of allergic disease (rhinitis or eczema) and neuropsychiatric disorder (tic disorder or OCD) need to be investigated in further studies with higher numbers of participants, and immune markers should be examined.

  17. A preliminary investigation of the relationship between dispositional mindfulness and eating disorder symptoms among men in residential substance use treatment.

    Science.gov (United States)

    Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott E; Stuart, Gregory L

    2017-01-01

    The comorbidity between eating disorders (EDs) and substance use disorders (SUDs) is of particular concern given the high rates of mortality, relapse and poor treatment outcomes associated with both disorders. As a result, there has been a growing impetus within the field to elucidate factors that might influence and aid treatment for this comorbidity. One such factor is dispositional mindfulness, as past literature has demonstrated a significant relationship between mindfulness and both EDs and SUDs. However, we are unaware of any research that has examined the relationship between dispositional mindfulness and ED symptoms in a sample of men in residential treatment for SUDs. Medical records from 152 men were included in the current study. Alcohol and drug use and problems, ED symptoms, and dispositional mindfulness were assessed with self-report measures. Hierarchical regression analysis indicated that dispositional mindfulness was inversely related to ED symptoms after controlling for alcohol use, drug use, and age. Although results are preliminary and continued research in this area is needed, our findings suggest that there may be potential usefulness in targeting and enhancing mindfulness among patients in residential treatment for SUDs with co-occurring psychiatric symptoms (e.g., EDs).

  18. Decreased gray matter volume of the medial orbitofrontal cortex in panic disorder with agoraphobia: a preliminary study.

    Science.gov (United States)

    Na, Kyoung-Sae; Ham, Byung-Joo; Lee, Min-Soo; Kim, Leen; Kim, Yong-Ku; Lee, Heon-Jeong; Yoon, Ho-Kyoung

    2013-08-01

    Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0 T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Binding of disordered peptides to kelch : insights from enhanced sampling simulations

    NARCIS (Netherlands)

    Do, T.N.; Choy, W.Y.; Karttunen, M.E.J.

    2016-01-01

    Keap1 protein plays an essential role in regulating cellular oxidative stress response and is a crucial binding hub for multiple proteins, several of which are intrinsically disordered proteins (IDP). Among Kelch's IDP binding partners, NRF2 and PTMA are the two most interesting cases. They share a

  20. Reliability of observer ratings in the assessment of personality disorders: a preliminary study.

    Science.gov (United States)

    Coolidge, F L; Burns, E M; Mooney, J A

    1995-01-01

    A 200-item, self-report personality disorder inventory (Coolidge Axis II Inventory; CATI) was administered to 52 married target subjects. Their spouses and a close friend completed a significant-other form about the targets. The mean correlation across all personality disorder scales was .51 for the targets-spouses, .36 for the targets-friends, and .41 for the spouses-friends. Twenty-eight target-spouse correlations were significant and ranged from .99 to -.40. The mean correlation for the individual 13 personality disorder scales was .46 for target-spouses and ranged from .63 for the histrionic scale to .27 for the paranoid scale. The results were interpreted as establishing a basis for significant other assessment of personality disorders.

  1. The Parental Fitness of Mothers with Multiple Personality Disorder: A Preliminary Study.

    Science.gov (United States)

    Kluft, Richard P.

    1987-01-01

    A review of the parenting patterns of 75 mothers with multiple personality disorders indicated 38.7% were competent or exceptional mothers, 16% were grossly abusive, and 45.3% were compromised or impaired as parents. (DB)

  2. Brief Cognitive Behavior Therapy in Patients with Social Anxiety Disorder: A Preliminary Investigation

    OpenAIRE

    Pinjarkar, Ravikant G; Sudhir, Paulomi M; Math, Suresh Bada

    2015-01-01

    Context: Cognitive behavior therapy (CBT) is the treatment of choice in anxiety disorders. However, there is little evidence for the effectiveness brief CBT in social anxiety. Aims: We examined the effectiveness of a brief CBT of six sessions in patients with social anxiety disorder. Settings and Design: A single case design study baseline; post and 1 month follow-up was adopted. Materials and Methods: Seven patients with a DSM IV diagnosis of social anxiety underwent 6 weekly sessions of bri...

  3. An insight into light as a chronobiological therapy in affective disorders

    Directory of Open Access Journals (Sweden)

    Walsh JM

    2014-10-01

    Full Text Available Jacqueline M Walsh, Lynsey A Atkinson, Sarah A Corlett, Gurprit S Lall Medway School of Pharmacy, University of Kent, Chatham, Kent, UK Abstract: The field of chronobiology has vastly expanded over the past few decades, bringing together research from the fields of circadian rhythms and sleep. The importance of the environmental day–night cycle on our health is becoming increasingly evident as we evolve into a 24-hour society. Reducing or changing sleep times against our natural instincts to rest at night has a detrimental impact on our well-being. The mammalian circadian clock, termed "the suprachiasmatic nucleus", is responsible for synchronizing our behavioral and physiological outputs to the environment. It utilizes light transcoded by specialized retinal photoreceptors as its cue to set internal rhythms to be in phase with the light–dark cycle. Misalignment of these outputs results in symptoms such as altered/disturbed sleep patterns, changes in mood, and physical and mental exhaustion – symptoms shared by many affective clinical disorders. Key links to circadian abnormalities have been found in a number of disorders, such as seasonal affective disorder, nonseasonal depression, and bipolar affective disorder. Furthermore, therapies developed through chronobiological research have been shown to be beneficial in the treatment of these conditions. In this article, we discuss the impact of circadian research on the management of affective disorders, giving evidence of how a misaligned circadian system may be a contributor to the symptoms of depression and how moderating circadian rhythms with light therapy benefits patients. Keywords: circadian, depression, SAD, nonseasonal, bipolar

  4. Molecular and genetic insights into an infantile epileptic encephalopathy – CDKL5 disorder

    Science.gov (United States)

    Zhou, Ailing; Han, Song

    2017-01-01

    Background The discovery that mutations in cyclin-dependent kinase-like 5 (CDKL5) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder. Given the large number of literature published thus far, this review aims to summarize current genetic studies, draw a consensus on proposed molecular functions, and point to gaps of knowledge in CDKL5 research. Methods A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years. We analyzed these publications and summarized the findings into four sections: genetic studies, CDKL5 expression patterns, molecular functions, and animal models. We also discussed challenges and future directions in each section. Results On the clinical side, CDKL5 disorder is characterized by early onset epileptic seizures, intellectual disability, and stereotypical behaviors. On the research side, a series of molecular and genetic studies in human patients, cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy, and pointed to a key role for CDKL5 in regulating neuronal function in the brain. Mouse models of CDKL5 disorder have also been developed, and notably, manifest behavioral phenotypes, mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage. Conclusions Given what we have learned thus far, future identification of robust, quantitative, and sensitive outcome measures would be the key in animal model studies, particularly in heterozygous females. In the meantime, molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes. PMID:28580010

  5. Molecular and genetic insights into an infantile epileptic encephalopathy - CDKL5 disorder.

    Science.gov (United States)

    Zhou, Ailing; Han, Song; Zhou, Zhaolan Joe

    2017-02-01

    The discovery that mutations in cyclin-dependent kinase-like 5 ( CDKL5 ) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder. Given the large number of literature published thus far, this review aims to summarize current genetic studies, draw a consensus on proposed molecular functions, and point to gaps of knowledge in CDKL5 research. A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years. We analyzed these publications and summarized the findings into four sections: genetic studies, CDKL5 expression patterns, molecular functions, and animal models. We also discussed challenges and future directions in each section. On the clinical side, CDKL5 disorder is characterized by early onset epileptic seizures, intellectual disability, and stereotypical behaviors. On the research side, a series of molecular and genetic studies in human patients, cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy, and pointed to a key role for CDKL5 in regulating neuronal function in the brain. Mouse models of CDKL5 disorder have also been developed, and notably, manifest behavioral phenotypes, mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage. Given what we have learned thus far, future identification of robust, quantitative, and sensitive outcome measures would be the key in animal model studies, particularly in heterozygous females. In the meantime, molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes.

  6. Molecular and genetic insights into an infantile epileptic encephalopathy-CDKL5 disorder

    Institute of Scientific and Technical Information of China (English)

    Ailing Zhou; Song Han; Zhaolan Joe Zhou

    2017-01-01

    BACKGROUND:The discovery that mutations in cyclin-dependent kinase-like 5 (CDKL5) gene are associated with infantile epileptic encephalopathy has stimulated world-wide research effort to understand the molecular and genetic basis of CDKL5 disorder.Given the large number of literature published thus far,this review aims to summarize current genetic studies,draw a consensus on proposed molecular functions,and point to gaps of knowledge in CDKL5 research.METHODS:A systematic review process was conducted using the PubMed search engine focusing on CDKL5 studies in the recent ten years.We analyzed these publications and summarized the findings into four sections:genetic studies,CDKL5 expression pattems,molecular functions,and animal models.We also discussed challenges and future directions in each section.RESULTS:On the clinical side,CDKL5 disorder is characterized by early onset epileptic seizures,intellectual disability,and stereotypical behaviors.On the research side,a series of molecular and genetic studies in human patients,cell cultures and animal models have established the causality of CDKL5 to the infantile epileptic encephalopathy,and pointed to a key role for CDKL5 in regulating neuronal function in the brain.Mouse models of CDKL5 disorder have also been developed,and notably,manifest behavioral phenotypes,mimicking numerous clinical symptoms of CDKL5 disorder and advancing CDKL5 research to the preclinical stage.CONCLUSIONS:Given what we have leamed thus far,future identification of robust,quantitative,and sensitive outcome measures would be the key in animal model studies,particularly in heterozygous females.In the meantime,molecular and cellular studies of CDKL5 should focus on mechanism-based investigation and aim to uncover druggable targets that offer the potential to rescue or ameliorate CDKL5 disorder-related phenotypes.

  7. Stigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders.

    Science.gov (United States)

    Staring, A B P; Van der Gaag, M; Van den Berge, M; Duivenvoorden, H J; Mulder, C L

    2009-12-01

    Good insight into illness in patients with schizophrenia is related not only to medication compliance and high service engagement, but also to depression, low self-esteem, and low quality of life. The detrimental effects of insight pose a problem for treatment. To investigate whether the negative associations of good insight are moderated by perceived stigma. Respondents were 114 patients with schizophrenia spectrum disorders. We used Analyses of Variance (ANOVA) and Structural Equation Modeling (SEM) to test moderation. Good insight was associated with high service engagement and high compliance. Also, good insight was associated with depressed mood, low quality of life, and negative self-esteem. This association was strong when stigma was high and weak when stigma was low. SEM showed that the constrained model performed significantly worse than the unconstrained model, in which detrimental associations of insight were free to vary across stigma groups (chi(2)=19.082; df=3; plow quality of life, and negative self-esteem are moderated by stigma. Patients with good insight who do not perceive much stigmatization seem to be best off across various outcome parameters. Those with poor insight have problems with service engagement and medication compliance. Patients with good insight accompanied by stigmatizing beliefs have the highest risk of experiencing low quality of life, negative self-esteem, and depressed mood. A clinical implication is that when it is attempted to increase insight, perceived stigma should also be addressed.

  8. A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood.

    Science.gov (United States)

    Matherne, Camden E; Tanofsky-Kraff, Marian; Altschul, Anne M; Shank, Lisa M; Schvey, Natasha A; Brady, Sheila M; Galescu, Ovidiu; Demidowich, Andrew P; Yanovski, Susan Z; Yanovski, Jack A

    2015-08-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (pdisordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (pdisordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. Published by Elsevier Ltd.

  9. [Variable magnetic fields in the treatment of tics disorders - preliminary results].

    Science.gov (United States)

    Pasek, Jarosław; Jędrzejewska, Anna; Jagodziński, Leszek; Obuchowicz, Anna; Flak, Maria; Sieroń, Aleksander

    Tics disorders is frequent pathological syndrome, particularly typical for children's age. The symptoms of this disease are differential, and their intensification individualized, which makes difficult unique recognition. Tics disorders concern the most often the muscles of face, head, upper limbs and trunk. The study group consisted of 16 patients (11 boys and 5 girls) with tics complex disorders about unknown etiology particularly relating of face and upper limbs muscles. In the treatment were the interventions with use a magnetotherapy and magnetostimulation applied. The procedures were ones daily by 3 weeks in two series executed. It author's pool was the frequency of occurrence tics disorders as well as the proportional opinion of effectiveness conducted treatment estimated. After 10 weeks in 14 patients was the decrease of occurrence frequency involuntary movements observed, in proportional scale about 75%. The results of subjective opinion of mood showed, that decrease the frequency tics disorders had in all children the direct shift on improvement their mood, and also satisfaction in their parents. The use of variable magnetic fields influenced on decrease the occurrence frequency tics disorders, and also on improvement quality of life the treated patients.

  10. A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood

    Science.gov (United States)

    Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.

    2015-01-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

  11. Blood lead levels in children with neurological disorders: a single centre preliminary study.

    Science.gov (United States)

    Mahmoudian, Touran; Modaresi, Mohamadreza; Zarei, Ali; Poursafa, Parinaz; Kelishadi, Roya

    2009-11-01

    Lead poisoning is a potentially devastating problem among young children. Chronic low level lead exposure can lead to learning disabilities and behavior changes such as colic, insomnia, hyperactivity, impaired growth, hearing loss and upper extremity weakness. The purpose of this cross sectional study was to determine the blood lead level in children with neurological disorders in comparison with healthy controls. Blood lead concentrations were measured by flame atomic absorption spectrometry in 100 children aged 1-10 years and suffering from various neurological disorders. One hundred age and sex-matched healthy children served as controls. The mean blood lead concentration was higher in children with neurological disorders than in controls (113.2 + or - 47.5 microg/L vs 84.7 + or - 38.0 microg/L; pchildren with neurological disorders and 19% of controls were found to have increased blood lead levels, i.e.>100 microg/L. An increase in blood lead level in children might be related to neurological disorders. The measurement of blood lead level might be included in diagnostic eveluation of children with neurological disorders.

  12. Spontaneous neural activity in the right superior temporal gyrus and left middle temporal gyrus is associated with insight level in obsessive-compulsive disorder.

    Science.gov (United States)

    Fan, Jie; Zhong, Mingtian; Gan, Jun; Liu, Wanting; Niu, Chaoyang; Liao, Haiyan; Zhang, Hongchun; Tan, Changlian; Yi, Jinyao; Zhu, Xiongzhao

    2017-01-01

    Insight into illness is an important issue for psychiatry disorder. Although the existence of a poor insight subtype of obsessive-compulsive disorder (OCD) was recognized in the DSM-IV, and the insight level in OCD was specified further in DSM-V, the neural underpinnings of insight in OCD have been rarely explored. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI). Spontaneous neural activity were examined in 19 OCD patients with good insight (OCD-GI), 18 OCD patients with poor insight (OCD-PI), and 25 healthy controls (HC) by analyzing the amplitude of low-frequency fluctuation (ALFF) in the resting state. Pearson correlation analysis was performed between regional ALFFs and insight levels among OCD patients. OCD-GI and OCD-PI demonstrated overlapping and distinct brain alterations. Notably, compared with OCD-GI, tOCD-PI had reduced ALFF in left middle temporal gyrus (MTG) and right superior temporal gyrus (STG), as well as increased ALFF in right middle occipital gyrus. Further analysis revealed that ALFF values for the left MTG and right STG were correlated negatively with insight level in patients with OCD. Relatively small sample size and not all patients were un-medicated are our major limitations. Spontaneous brain activity in left MTG and right STG may be neural underpinnings of insight in OCD. Our results suggest the great role of human temporal brain regions in understanding insight, and further underscore the importance of considering insight presentation in understanding the clinical heterogeneity of OCD. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Circadian Rhythm Disturbances in Mood Disorders: Insights into the Role of the Suprachiasmatic Nucleus

    Science.gov (United States)

    2017-01-01

    Circadian rhythm disturbances are a common symptom among individuals with mood disorders. The suprachiasmatic nucleus (SCN), in the ventral part of the anterior hypothalamus, orchestrates physiological and behavioral circadian rhythms. The SCN consists of self-sustaining oscillators and receives photic and nonphotic cues, which entrain the SCN to the external environment. In turn, through synaptic and hormonal mechanisms, the SCN can drive and synchronize circadian rhythms in extra-SCN brain regions and peripheral tissues. Thus, genetic or environmental perturbations of SCN rhythms could disrupt brain regions more closely related to mood regulation and cause mood disturbances. Here, we review clinical and preclinical studies that provide evidence both for and against a causal role for the SCN in mood disorders. PMID:29230328

  14. Effect of Treating Anxiety Disorders on Cognitive Deficits and Behaviors Associated with Attention Deficit Hyperactivity Disorder: A Preliminary Study.

    Science.gov (United States)

    Denis, Isabelle; Guay, Marie-Claude; Foldes-Busque, Guillaume; BenAmor, Leila

    2016-06-01

    Twenty-five percent of children with ADHD also have an anxiety disorder (AD). As per Quay and in light of Barkley's model, anxiety may have a protective effect on cognitive deficits and behaviors associated with ADHD. This study aimed to evaluate the effect of treating AD on cognitive deficits and behaviors associated with ADHD in children with both disorders. Twenty-four children with ADHD and AD were divided into two groups: treatment for AD, and wait list. Participants were assessed at pre-treatment, post-treatment, and 6-month follow-up with the ADIS-C, the CBCL, and neuropsychological measures. The results revealed a significant improvement in automatic response inhibition and flexibility, and a decrease in inattention/hyperactivity behaviors following the treatment for AD. No significant differences were observed in motor response inhibition, working memory, or attention deficits. The results do not seem to support Quay's hypothesis: treating AD did not exacerbate cognitive deficits and behaviors associated with ADHD in our sample.

  15. Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial.

    Science.gov (United States)

    Steiner, Naomi J; Sheldrick, Radley Christopher; Gotthelf, David; Perrin, Ellen C

    2011-07-01

    Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

  16. New insights into the role of motion and form vision in neurodevelopmental disorders.

    Science.gov (United States)

    Johnston, Richard; Pitchford, Nicola J; Roach, Neil W; Ledgeway, Timothy

    2017-12-01

    A selective deficit in processing the global (overall) motion, but not form, of spatially extensive objects in the visual scene is frequently associated with several neurodevelopmental disorders, including preterm birth. Existing theories that proposed to explain the origin of this visual impairment are, however, challenged by recent research. In this review, we explore alternative hypotheses for why deficits in the processing of global motion, relative to global form, might arise. We describe recent evidence that has utilised novel tasks of global motion and global form to elucidate the underlying nature of the visual deficit reported in different neurodevelopmental disorders. We also examine the role of IQ and how the sex of an individual can influence performance on these tasks, as these are factors that are associated with performance on global motion tasks, but have not been systematically controlled for in previous studies exploring visual processing in clinical populations. Finally, we suggest that a new theoretical framework is needed for visual processing in neurodevelopmental disorders and present recommendations for future research. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Major depressive disorder: insight into candidate cerebrospinal fluid protein biomarkers from proteomics studies.

    Science.gov (United States)

    Al Shweiki, Mhd Rami; Oeckl, Patrick; Steinacker, Petra; Hengerer, Bastian; Schönfeldt-Lecuona, Carlos; Otto, Markus

    2017-06-01

    Major Depressive Disorder (MDD) is the leading cause of global disability, and an increasing body of literature suggests different cerebrospinal fluid (CSF) proteins as biomarkers of MDD. The aim of this review is to summarize the suggested CSF biomarkers and to analyze the MDD proteomics studies of CSF and brain tissues for promising biomarker candidates. Areas covered: The review includes the human studies found by a PubMed search using the following terms: 'depression cerebrospinal fluid biomarker', 'major depression biomarker CSF', 'depression CSF biomarker', 'proteomics depression', 'proteomics biomarkers in depression', 'proteomics CSF biomarker in depression', and 'major depressive disorder CSF'. The literature analysis highlights promising biomarker candidates and demonstrates conflicting results on others. It reveals 42 differentially regulated proteins in MDD that were identified in more than one proteomics study. It discusses the diagnostic potential of the biomarker candidates and their association with the suggested pathologies. Expert commentary: One ultimate goal of finding biomarkers for MDD is to improve the diagnostic accuracy to achieve better treatment outcomes; due to the heterogeneous nature of MDD, using bio-signatures could be a good strategy to differentiate MDD from other neuropsychiatric disorders. Notably, further validation studies of the suggested biomarkers are still needed.

  18. Co-occurrence of personality disorders in persons with kleptomania: a preliminary investigation.

    Science.gov (United States)

    Grant, Jon E

    2004-01-01

    This study was conducted to examine the co-occurrence of personality disorders in a group of persons with kleptomania. Twenty-eight subjects with DSM-IV kleptomania were administered the Structured Clinical Interview for DSM-III-R Personality Disorders and a semistructured interview to assess demographics and clinical characteristics. Twelve subjects with kleptomania (42.9%) met criteria for at least one personality disorder. The most common were: paranoid (n = 5; 17.9%), schizoid (n = 3; 10.7%), and borderline (n = 3; 10.7%). Subjects with kleptomania combined with personality disorders had an earlier age of onset of stealing behavior (13.4 +/- 5.6 years compared with 27.4 +/- 14.2 years in those who had kleptomania only; t = 3.225; df = 26; p = .006). Severity of kleptomania symptoms did not differ among the Axis II comorbidities. Persons with kleptomania appear to have a high prevalence of personality disorders. Further studies are needed to understand the relationship of kleptomania to personality.

  19. Neuromyelitis optica spectrum disorders in Algeria: A preliminary study in the region of Tizi Ouzou.

    Science.gov (United States)

    Daoudi, Smail; Bouzar, Melissa

    2016-03-01

    Neuromyelitis optica (NMO) is a disabling inflammatory condition that targets astrocytes in the optic nerves and spinal cord. Recent advances led to the individualization of a set of conditions now referred as NMO spectrum disorder (NMOSD). To describe the prevalence and characteristics of NMO SD in north Algeria. The present study is a retrospective and descriptive work which took place in Nedir Mohamed teaching hospital, Tizi-Ouzou, Algeria. 938 Medical files of patients with CNS inflammatory demyelinating diseases were reviewed then patients with optic neuritis and/or myelitis were preselected. Patients who met the 2015 neuromyelitis optica spectrum disorders criteria were selected and analyzed 08 Patients (3.4%) met the 2015 criteria for neuromyelitis optica spectrum disorders, 3/8 (37.5%) were positive to AQ4-IgG and 5/8 (62.5%) were negative. Mean age of onset was 29 years, female to male ratio was 3:1, cerebral MRI was normal in 75% of cases and longitudinally extensive transverse myelitis was present in 75% of cases. 37/232 Patients (15.9%) were considered at high risk of neuromyelitis optica spectrum disorders The present study suggests that the spectrum of NMO disorders is a rare entity among patients with optic nerve and spinal cord demyelinating lesions in north Algeria. However, the lack of accurate AQ4-IgG test certainly underestimates its real prevalence. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

    NARCIS (Netherlands)

    Tak, E.C.P.M.; Hespen, A.T.H. van; Verhaak, P.F.M.; Eekhof, J.; Hopman-Rock, M.

    2016-01-01

    Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety,

  1. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP)

    NARCIS (Netherlands)

    Tak, E.C.P.M.; Hespen, A.T.H. van; Verhaal, P.F.M.; Eekhof, J.; Hopman-Rock, M.

    2016-01-01

    Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety,

  2. Listvenite formation from peridotite: Insights from Oman Drilling Project hole BT1B and preliminary reaction path model approach.

    Science.gov (United States)

    de Obeso, J. C.; Kelemen, P. B.; Manning, C. E.; Michibayashi, K.; Harris, M.

    2017-12-01

    Oman Drilling Project hole BT1B drilled 300 meters through the basal thrust of the Samail ophiolite. The first 200 meters of this hole are dominated by listvenites (completely carbonated peridotites) and serpentinites. Below 200 meters the hole is mainly composed of metasediments and metavolcanics. This core provides a unique record of interaction between (a) mantle peridotite in the leading edge of the mantle wedge and (b) hydrous, CO2 rich fluids derived from subducting lithologies similar to those in the metamorphic sole. We used EQ3/6 to simulate a reaction path in which hydrous fluid in equilibrium with qtz + calcite + feldspar + chlorite or smectite reacts with initially fresh peridotite at 100°C (the estimated temperature of alteration, Falk & Kelemen GCA 2015) and 5 kb. Water was first equilibrated with minerals observed during core description in the metamorphic sole at 100°C and 5kb. This fluid is then reacted with olivine enstatite and diopside (Mg#90) approximating the average composition of residual mantle peridotite (harzburgite) in Oman. Secondary minerals resulting from complete reaction are then reacted again with the initial fluid in an iterative process, up to water/rock > 1000. Water/rock close to 1 results in complete serpentinization of the peridotite, with chrysotile, brucite and magnetite as the only minerals. Water/rock >10 produces carbonates, chlorite and talc. Further increasing water/rock to > 100 produces assemblages dominated by carbonates and quartz with minor muscovite, similar to listvenites of hole BT1B that contain qtz + carbonates + Fe-oxyhydroxides + relict spinel ± chromian muscovite and fuchsite. The results of this preliminary model are consistent with the complex veining history of core from BT1B, with carbonate/iron oxide veins in both listvenites and serpentinites interpreted to be the earliest record of peridotite carbonation after initial serpentinization.

  3. Atrioventricular canal defect and associated genetic disorders: new insights into polydactyly syndromes

    Directory of Open Access Journals (Sweden)

    M. Cristina Digilio

    2011-07-01

    Full Text Available Atrioventricular canal defect (AVCD is a common congenital heart defect (CHD, representing 7.4% of all cardiac malformations, considered secondary to an extracellular matrix anomaly. The AVCD is associated with extracardiac defects in about 75% of the cases. In this review we analyzed different syndromic AVCDs, in particular those associated with polydactyly disorders, which show remarkable genotype-phenotype correlations. Chromo - some imbalances more frequently associated with AVCD include Down syndrome, deletion 8p23 and deletion 3p25, while mendelian disorders include Noonan syndrome and related RASopathies, several polydactyly syndromes, CHARGE and 3C (cranio-cerebello-cardiac syndrome. The complete form of AVCD is prevalent in patients with chromosomal imbalances. Additional cardiac defects are found in patients affected by chromosomal imbalances different from Down syndrome. Left-sided obstructive lesions are prevalently found in patients with RASopathies. Patients with deletion 8p23 often display AVCD with tetralogy of Fallot or with pulmonary valve stenosis. Tetralogy of Fallot is the only additional cardiac defect found in patients with Down syndrome and AVCD. On the other hand, the association of AVCD and tetralogy of Fallot is also quite characteristic of CHARGE and 3C syndromes. Heterotaxia defects, including common atrium and anomalous pulmonary venous return, occur in patients with AVCD associated with polydactyly syndromes (Ellis-van Creveld, short rib polydactyly, oral-facial-digital, Bardet-Biedl, and Smith-Lemli-Opitz syndromes. The initial clinical evidence of anatomic similarities between AVCD and heterotaxia in polydactyly syndromes was corroborated and explained by experimental studies in transgenic mice. These investigations have suggested the involvement of the Sonic Hedgehog pathway in syndromes with postaxial polydactyly and heterotaxia, and ciliary dysfunction was detected as pathomechanism for these disorders

  4. Insights into the genetics of gastroesophageal reflux disease (GERD) and GERD-related disorders.

    Science.gov (United States)

    Böhmer, A C; Schumacher, J

    2017-02-01

    Gastroesophageal reflux disease (GERD) is associated with obesity and hiatal hernia, and often precedes the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EA). Epidemiological studies show that the global prevalence of GERD is increasing. GERD is a multifactorial disease with a complex genetic architecture. Genome-wide association studies (GWAS) have provided initial insights into the genetic background of GERD. The present review summarizes current knowledge of the genetics of GERD and a possible genetic overlap between GERD and BE and EA. The review discusses genes and cellular pathways that have been implicated through GWAS, and provides an outlook on how future molecular research will enhance understanding of GERD pathophysiology. © 2017 John Wiley & Sons Ltd.

  5. Metacognitive reflective and insight therapy for people in early phase of a schizophrenia spectrum disorder.

    Science.gov (United States)

    Hillis, Jaclyn D; Leonhardt, Bethany L; Vohs, Jenifer L; Buck, Kelly D; Salvatore, Giampaolo; Popolo, Raffaele; Dimaggio, Giancarlo; Lysaker, Paul H

    2015-02-01

    Schizophrenia often involves a loss of metacognitive capacity, the ability to form complex and integrated representations of self and others. Independent of symptoms and neurocognition, deficits in synthetic metacognition are related to difficulties of engaging in goal-directed activities in social and vocational settings. Within this backdrop, we provide a case report of the effects of Metacognitive Reflective Insight Therapy (MERIT) that assisted a patient suffering from first episode schizophrenia during 2 years of individual psychotherapy. A total of 8 elements of MERIT that stimulate and promote metacognitive capacity are presented. As illustrated in this report, these procedures helped the patient move from a state in which he had virtually no complex ideas about himself or others to one in which he had developed integrated and realistic ideas about his own identity and the identity of others. He then could use these representations to understand and effectively respond to life challenges. © 2014 Wiley Periodicals, Inc.

  6. Deploying innovations in wearable technology to gain insight into clinical disorders and their treatment

    DEFF Research Database (Denmark)

    Parsons, Christine; Jensen, Kasper Løvborg; Linehan, Conor

    a smartphone application that can gather and analyse physiological and behavioural data securely. From testing wearable device capacities, we suggest that resting sleeping heart rate may comprise a measurable index of physiological functioning. This measure, together with behavioural indices, such as daily......, but infrequent assessment. Wearable technology can provide new ways to understand physiology beyond the laboratory. In order to harness this potential, we need to develop methods to monitor patients unobtrusively, with minimal patient burden, and due concern for privacy issues. Furthermore, we need to ensure...... rhythmic patterns of activity, may provide new insights into patient functioning. Furthermore, high-frequency recording, over extended periods as available from wearable devices, will provide us with a temporally-sensitive means to investigate treatment effects....

  7. The Fanconi anemia DNA repair pathway: structural and functional insights into a complex disorder.

    Science.gov (United States)

    Walden, Helen; Deans, Andrew J

    2014-01-01

    Mutations in any of at least sixteen FANC genes (FANCA-Q) cause Fanconi anemia, a disorder characterized by sensitivity to DNA interstrand crosslinking agents. The clinical features of cytopenia, developmental defects, and tumor predisposition are similar in each group, suggesting that the gene products participate in a common pathway. The Fanconi anemia DNA repair pathway consists of an anchor complex that recognizes damage caused by interstrand crosslinks, a multisubunit ubiquitin ligase that monoubiquitinates two substrates, and several downstream repair proteins including nucleases and homologous recombination enzymes. We review progress in the use of structural and biochemical approaches to understanding how each FANC protein functions in this pathway.

  8. Metacognition and negative emotions in clinical practice. A preliminary study with patients with bowel disorder

    Directory of Open Access Journals (Sweden)

    Vittorio Lenzo

    2013-09-01

    Full Text Available In the past few years psychological characteristics in patients with organic bowel disorder have been poorly considered. However recent studies underline that psychological features increase gastrointestinal symptoms. The aim of this study is to investigate metacognition and emotions in patients with organic bowel disorder and functional bowel disorder. 33 outpatients with organic diagnosis and 28 outpatients with functional diagnosis were assessed with MCQ-30, ANPS and Brief-Cope; moreover stress was evaluated in all outpatients.  Results revealed that two groups show the same psychological disturbances and there are no differences between organic patients and functional patients. Statistical analysis indicated significant relations between dysfunctional metacognitive beliefs and negative emotions. Specifically, Beliefs of Uncontrollability and Danger (UD are significantly related to Fear, Anger and Sadness. Moreover Fear and Anger are significantly related to stress; dysfunctional metacognitive beliefs are related to coping strategies. Beliefs of UD are related to Using Emotional Support; Positive Beliefs (PB are related to Planning, while Cognitive Confidence (CC is related to Self-Blame. Unexpectedly results are higher in patients with organic diagnosis. Our results suggest to reconsider psychological influences in patients with organic diagnosis of gastrointestinal disease. Keywords:Metacognition; Inflammatory bowel diseases; Functional gastrointestinal disorders; Emotions; Coping; 

  9. Brief Report: Feasibility and Preliminary Efficacy of Individual Mindfulness Therapy for Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Conner, Caitlin M.; White, Susan W.

    2018-01-01

    Intervention research on adults with autism spectrum disorder (ASD) is sparse. Many adults with ASD experience impaired emotion regulation (ER), which is thought to contribute to higher rates of psychiatric comorbidities among adults with ASD and indirect effects upon adaptive functioning, interpersonal relationships, and vocational status. The…

  10. Preliminary observations on the effectiveness of levetiracetam in the open adjunctive treatment of refractory bipolar disorder

    NARCIS (Netherlands)

    Post, RM; Altshuler, LL; Frye, MA; Suppes, T; McElroy, SL; Keck, PE; Leverich, GS; Kupka, R; Nolen, WA; Luckenbaugh, DA; Walden, J; Grunze, H

    Objective: Levetiracetam is a recently approved, well-tolerated anticonvulsant with a unique mechanism of action yielding efficacy in treatment-refractory seizure disorders and positive effects in an animal model of mania. Given the effectiveness of a range of other anticonvulsants in bipolar

  11. The Relationship between Clinical Presentation and Unusual Sensory Interests in Autism Spectrum Disorders: A Preliminary Investigation

    Science.gov (United States)

    Zachor, Ditza A.; Ben-Itzchak, Esther

    2014-01-01

    Unusual responses to sensory stimuli have been described in autism spectrum disorder (ASD).The study examined the frequencies of "unusual sensory interests" and "negative sensory responses" and their relation to functioning in a large ASD population (n = 679). Having "unusual sensory interests" was reported in 70.4%…

  12. Creativity, Bipolar Disorder Vulnerability and Psychological Well-Being: A Preliminary Study

    Science.gov (United States)

    Gostoli, Sara; Cerini, Veronica; Piolanti, Antonio; Rafanelli, Chiara

    2017-01-01

    The aim of this research was to investigate the relationships between creativity, subclinical bipolar disorder symptomatology, and psychological well-being. The study method was of descriptive, correlational type. Significant tests were performed using multivariate regression analysis. Students of the 4th grade of 6 different Italian colleges…

  13. A Preliminary Study of Gender Differences in Autobiographical Memory in Children with an Autism Spectrum Disorder

    Science.gov (United States)

    Goddard, Lorna; Dritschel, Barbara; Howlin, Patricia

    2014-01-01

    Autobiographical memory was assessed in 24 children (12 male, 12 female, aged between 8 and 16 years) with autism spectrum disorder (ASD) and a comparison group of 24 typically developing (TD) children matched for age, IQ, gender and receptive language. Results suggested that a deficit in specific memory retrieval in the ASD group was more…

  14. Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

    Science.gov (United States)

    Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

    2012-01-01

    This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

  15. Preliminary evidence for a role of the adrenergic nervous system in generalized anxiety disorder.

    Science.gov (United States)

    Zhang, Xiaobin; Norton, Joanna; Carrière, Isabelle; Ritchie, Karen; Chaudieu, Isabelle; Ryan, Joanne; Ancelin, Marie-Laure

    2017-02-15

    Generalized anxiety disorder (GAD) is a common chronic condition that is understudied compared to other psychiatric disorders. An altered adrenergic function has been reported in GAD, however direct evidence for genetic susceptibility is missing. This study evaluated the associations of gene variants in adrenergic receptors (ADRs) with GAD, with the involvement of stressful events. Data were obtained from 844 French community-dwelling elderly aged 65 or over. Anxiety disorders were assessed using the Mini-International Neuropsychiatry Interview, according to DSM-IV criteria. Eight single-nucleotide polymorphisms (SNPs) involved with adrenergic function were genotyped; adrenergic receptors alpha(1A) (ADRA1A), alpha(2A) (ADRA2A), and beta2 (ADRB2) and transcription factor TCF7L2. Questionnaires evaluated recent stressful life events as well as early environment during childhood and adolescence. Using multivariate logistic regression analyses four SNPs were significantly associated with GAD. A 4-fold modified risk was found with ADRA1A rs17426222 and rs573514, and ADRB2 rs1042713 which remained significant after Bonferroni correction. Certain variants may moderate the effect of adverse life events on the risk of GAD. Replication in larger samples is needed due to the small case number. This is the first study showing that ADR variants are susceptibility factors for GAD, further highlighting the critical role of the adrenergic nervous system in this disorder.

  16. [The epidemiology of suicide in bipolar disorder in the manic episode--preliminary reports].

    Science.gov (United States)

    Wierzbiński, Piotr; Zdanowicz, Anna; Klekowska, Justyna; Broniarczyk-Czarniak, Marta; Zboralski, Krzysztof

    2014-04-01

    Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder. The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated. Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide. A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

  17. The hypocretin/orexin system in sleep disorders: preclinical insights and clinical progress

    Directory of Open Access Journals (Sweden)

    Chow M

    2016-03-01

    Full Text Available Matthew Chow, Michelle CaoDepartment of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Much of the understanding of the hypocretin/orexin (HCRT/OX system in sleep–wake regulation came from narcolepsy–cataplexy research. The neuropeptides hypocretin-1 and -2/orexin-A and -B (HCRT-1 and -2/OX-A and -B, respectively, as we know, are intimately involved in the regulation wakefulness. The HCRT/OX system regulates sleep–wake control through complex interactions between monoaminergic/cholinergic (wake-promoting and gamma-aminobutyric acid-ergic (sleep-promoting neuronal systems. Deficiency of HCRT/OX results in loss of sleep–wake control or stability with consequent unstable transitions between wakefulness to nonrapid eye movement and rapid eye movement sleep. This manifests clinically as abnormal daytime sleepiness with sleep attacks and cataplexy. Research on the development of HCRT/OX agonists and antagonists for the treatment of sleep disorders has dramatically increased with the US Food and Drug Administration approval of the first-in-class dual HCRT/OX receptor antagonist for the treatment of insomnia. This review focuses on the origin, mechanisms of HCRT/OX receptors, clinical progress, and applications for the treatment of sleep disorders.Keywords: hypocretin, orexin, narcolepsy, insomnia, orexin antagonist, orexin agonist

  18. New insights into secondary prevention in post-traumatic stress disorder

    Science.gov (United States)

    Zohar, Joseph; Juven-Wetzler, Alzbeta; Sonnino, Rachel; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Cohen, Hagit

    2011-01-01

    Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies. PMID:22033784

  19. The hypocretin/orexin system in sleep disorders: preclinical insights and clinical progress.

    Science.gov (United States)

    Chow, Matthew; Cao, Michelle

    2016-01-01

    Much of the understanding of the hypocretin/orexin (HCRT/OX) system in sleep-wake regulation came from narcolepsy-cataplexy research. The neuropeptides hypocretin-1 and -2/orexin-A and -B (HCRT-1 and -2/OX-A and -B, respectively), as we know, are intimately involved in the regulation wakefulness. The HCRT/OX system regulates sleep-wake control through complex interactions between monoaminergic/cholinergic (wake-promoting) and gamma-aminobutyric acid-ergic (sleep-promoting) neuronal systems. Deficiency of HCRT/OX results in loss of sleep-wake control or stability with consequent unstable transitions between wakefulness to nonrapid eye movement and rapid eye movement sleep. This manifests clinically as abnormal daytime sleepiness with sleep attacks and cataplexy. Research on the development of HCRT/OX agonists and antagonists for the treatment of sleep disorders has dramatically increased with the US Food and Drug Administration approval of the first-in-class dual HCRT/OX receptor antagonist for the treatment of insomnia. This review focuses on the origin, mechanisms of HCRT/OX receptors, clinical progress, and applications for the treatment of sleep disorders.

  20. Courtesy stigma in mothers of children with Attention-Deficit/Hyperactivity Disorder: a preliminary investigation.

    Science.gov (United States)

    Norvilitis, J M; Scime, M; Lee, J S

    2002-09-01

    Mothers of children with Attention-Deficit/Hyperactivity Disorder face an increased risk for depression, anxiety, and social isolation. In addition to stress due to children's behavior, mothers of children with ADHD may also feel stigmatized by their children's diagnosis. Fifty-one mothers participated in a study to assess attitudes toward ADHD. Although mothers of children with ADHD expected that parents of children without ADHD would hold harsh views of the disorder, this was not generally the case. This difference between perception and the actual self-reported views of mothers of children without ADHD supports the idea that mothers feel stigmatized but suggests that increased awareness might help mothers of children with ADHD feel less isolated.

  1. Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders

    Science.gov (United States)

    Peterson, Gunnel; Nilsson, David; Trygg, Johan; Falla, Deborah; Dedering, Åsa; Wallman, Thorne; Peolsson, Anneli

    2015-01-01

    Chronic whiplash-associated disorder (WAD) is common after whiplash injury, with considerable personal, social, and economic burden. Despite decades of research, factors responsible for continuing pain and disability are largely unknown, and diagnostic tools are lacking. Here, we report a novel model of mechanical ventral neck muscle function recorded from non-invasive, real-time, ultrasound measurements. We calculated the deformation area and deformation rate in 23 individuals with persistent WAD and compared them to 23 sex- and age-matched controls. Multivariate statistics were used to analyse interactions between ventral neck muscles, revealing different interplay between muscles in individuals with WAD and healthy controls. Although the cause and effect relation cannot be established from this data, for the first time, we reveal a novel method capable of detecting different neck muscle interplay in people with WAD. This non-invasive method stands to make a major breakthrough in the assessment and diagnosis of people following a whiplash trauma. PMID:26472599

  2. White Matter Changes in Bipolar Disorder, Alzheimer Disease, and Mild Cognitive Impairment: New Insights from DTI

    Directory of Open Access Journals (Sweden)

    Aikaterini Xekardaki

    2011-01-01

    Full Text Available Neuropathological and neuroimaging studies have reported significant changes in white matter in psychiatric and neurodegenerative diseases. Diffusion tensor imaging (DTI, a recently developed technique, enables the detection of microstructural changes in white matter. It is a noninvasive in vivo technique that assesses water molecules' diffusion in brain tissues. The most commonly used parameters are axial and radial diffusivity reflecting diffusion along and perpendicular to the axons, as well as mean diffusivity and fractional anisotropy representing global diffusion. Although the combination of these parameters provides valuable information about the integrity of brain circuits, their physiological meaning still remains controversial. After reviewing the basic principles of DTI, we report on recent contributions that used this technique to explore subtle structural changes in white matter occurring in elderly patients with bipolar disorder and Alzheimer disease.

  3. Emotion regulation and Residual Depression Predict Psychosocial Functioning in Bipolar Disorder: Preliminary Study

    OpenAIRE

    Becerra, Rodrigo; Cruise, Kate; Harms, Craig; Allan, Alfred; Bassett, Darryl; Hood, Sean; Murray, Greg

    2015-01-01

    This study explores the predictive value of various clinical, neuropsychological, functional, and emotion regulation processes for recovery in Bipolar Disorder. Clinical and demographic information was collected for 27 euthymic or residually depressed BD participants. Seventy one percent of the sample reported some degree of impairment in psychosocial functioning. Both residual depression and problems with emotion regulation were identified as significant predictors of poor psychosocial funct...

  4. Mitochondrial dysfunction in fatty acid oxidation disorders: insights from human and animal studies.

    Science.gov (United States)

    Wajner, Moacir; Amaral, Alexandre Umpierrez

    2015-11-20

    Mitochondrial fatty acid oxidation (FAO) plays a pivotal role in maintaining body energy homoeostasis mainly during catabolic states. Oxidation of fatty acids requires approximately 25 proteins. Inherited defects of FAO have been identified in the majority of these proteins and constitute an important group of inborn errors of metabolism. Affected patients usually present with severe hepatopathy, cardiomyopathy and skeletal myopathy, whereas some patients may suffer acute and/or progressive encephalopathy whose pathogenesis is poorly known. In recent years growing evidence has emerged indicating that energy deficiency/disruption of mitochondrial homoeostasis is involved in the pathophysiology of some fatty acid oxidation defects (FAOD), although the exact underlying mechanisms are not yet established. Characteristic fatty acids and carnitine derivatives are found at high concentrations in these patients and more markedly during episodes of metabolic decompensation that are associated with worsening of clinical symptoms. Therefore, it is conceivable that these compounds may be toxic. We will briefly summarize the current knowledge obtained from patients and genetic mouse models with these disorders indicating that disruption of mitochondrial energy, redox and calcium homoeostasis is involved in the pathophysiology of the tissue damage in the more common FAOD, including medium-chain acyl-CoA dehydrogenase (MCAD), long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiencies. We will also provide evidence that the fatty acids and derivatives that accumulate in these diseases disrupt mitochondrial homoeostasis. The elucidation of the toxic mechanisms of these compounds may offer new perspectives for potential novel adjuvant therapeutic strategies in selected disorders of this group. © 2016 Authors.

  5. Decreases in smoking during treatment for methamphetamine-use disorders: preliminary evidence.

    Science.gov (United States)

    McPherson, Sterling; Orr, Michael; Lederhos, Crystal; McDonell, Michael; Leickly, Emily; Hirchak, Katherine; Oluwoye, Oladunni A; Murphy, Sean M; Layton, Matthew; Roll, John M

    2018-06-01

    Despite high rates of smoking (70-90%) and the severely negative impact of smoking on physical and mental health, only 12% of individuals receiving stimulant-use disorder treatment also receive smoking-cessation treatment. The aim of this investigation was to examine the effect of a contingency management (CM) intervention targeting methamphetamine (MA) use on cigarette smoking. Sixty-one adults with MA-use disorders who were smokers were assigned to CM or standard psychosocial treatment. Rates of smoking-negative breath samples (carbon monoxide <3 ppm) were compared between the two groups while controlling for baseline carbon monoxide level, marijuana use, MA use, and time. This subgroup of mostly male (59%) participants included 44 participants in the CM group and 17 participants in the standard psychosocial treatment. Tobacco smoking participants who received CM targeting MA use were 140% (odds ratio: 2.395; 95% confidence interval: 1.073-5.346) more likely to submit a smoking-negative breath sample relative to standard psychosocial treatment during the treatment period, holding constant several other prespecified covariates. This study provides evidence that a behavioral treatment for MA use results in reductions in cigarette smoking in adults with MA-use disorder.

  6. Executive functions in children with chronic tic disorders with/without ADHD: new insights.

    Science.gov (United States)

    Roessner, Veit; Becker, Andreas; Banaschewski, Tobias; Rothenberger, Aribert

    2007-06-01

    In Chronic Tic Disorders (CTD) associated Attention Deficit Hyperactivity Disorder (ADHD) is very common. Hence, it is important to clarify how both conditions are related to cognitive dysfunctions in patients with CTD+ADHD comorbidity. Recent studies on neuropsychology revealed equivocal results, mostly due to methodological shortcomings like problems in sample composition. Thus better and more detailed information on this topic is needed to improve diagnostic and treatment approaches. Three tasks related to different domains of executive functions (the Matching Familiar Figures Test, the Stroop color-word interference task, and a computerized version of the Wisconsin Card Sorting Test) have been performed in two independent samples (altogether n = 138 children) both including four groups of children (CTD-only, CTD+ADHD, ADHD-only, healthy controls) matched for age and IQ. To specify the influence of either tics or ADHD-symptoms on executive functions and to answer the question of their interactive or additive relationship two-way analyses of variance (MANOVA) for the factors CTD (yes,-no) x ADHD (yes,no) were conducted. Eta squared was calculated to reveal the effect sizes for each factor. For a deeper understanding of group differences and to better enable the comparison with data in literature, additional analyses of variance (ANOVA) with posthoc testing were applied. In summary, there was a main effect only for the factor ADHD reflected by decreased performance, while no main effect of the factor CTD could be found. Admittedly, the effects were not uniform in both samples. However, in all three tasks and both samples, uniformly no interaction between the main factors has been observed. In cases of coexisting CTD+ADHD the factor ADHD shows the main negative impact on neuropsychological performance and this impact seems to be independent of any feature of the coexisting tics (additive model). This supports the notion to primarily treat the ADHD-symptoms in order

  7. Perception ofown body by women with borderline personality disorderpreliminary studies

    Directory of Open Access Journals (Sweden)

    Aleksandra Szepietowska

    2014-03-01

    Full Text Available Aim: Analysis of the way women with borderline personality disorder (BPD perceive their bodies. Methods: The body perception was presented as a psychological model manifested in the attitude to one’s own body, the way of sensing and interpreting the bodily sensations, mental identification with the body, and the feeling of comfort in interpersonal closeness and social exposure situations. Material and methods: Twenty eight women took part in the study: 14 of them met the BPD criteria, 14 constituted a comparative group (selection by pairs. Three instruments were used: The Symptom Checklist-90 (SCL-90, self-constructed questionnaire examining one’s own body perception (Body Perception Scale – Skala Percepcji Ciała, SPC, and Borderline Scale from Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II to confirm BPD symptoms. Results: Women with BPD perceive their bodies more negatively in all examined aspects, as compared to those without personality disorders. Predominant are negative emotions towards one’s body and lack of confidence in one’s attraction for other people. Less intense become such traits as: the impression of perceptive changes, difficulty in identification with the body appearance, and avoidance of close physical contacts. Comparisons of SCL-90 results show that in women with BPD all psychopathological symptoms are more severe. These patients are characterized by an increased level of depressiveness, obsessive-compulsive traits, paranoid ideation, and psychoticism. The results profile shows a similar pattern of symptoms in both groups and it is not the type but severity of psychopathological symptoms that differentiates them.

  8. Action control processes in autism spectrum disorder--insights from a neurobiological and neuroanatomical perspective.

    Science.gov (United States)

    Chmielewski, Witold X; Beste, Christian

    2015-01-01

    Autism spectrum disorders (ASDs) encompass a range of syndromes that are characterized by social interaction impairments, verbal and nonverbal communication difficulties, and stereotypic or repetitive behaviours. Although there has been considerable progress in understanding the mechanisms underlying the changes in the 'social' and 'communicative' aspects of ASD, the neurofunctional architecture of repetitive and stereotypic behaviours, as well as other cognitive domains related to response and action control, remain poorly understood. Based on the findings of neurobiological and neuroanatomical alterations in ASD and the functional neuroanatomy and neurobiology of different action control functions, we emphasize that changes in action control processes, including response inhibition, conflict and response monitoring, task switching, dual-tasking, motor timing, and error monitoring, are important facets of ASD. These processes must be examined further to understand the executive control deficits in ASD that are related to stereotypic or repetitive behaviours as a major facet of ASD. The review shows that not all domains of action control are strongly affected in ASD. Several factors seem to determine the consistency with which alterations in cognitive control are reported. These factors relate to the relevance of neurobiological changes in ASD for the cognitive domains examined and in how far action control relies upon the adjustment of prior experience. Future directions and hypotheses are outlined that may guide basic and clinical research on action control in ASD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Systems Factorial Technology provides new insights on global-local information processing in autism spectrum disorders.

    Science.gov (United States)

    Johnson, Shannon A; Blaha, Leslie M; Houpt, Joseph W; Townsend, James T

    2010-02-01

    Previous studies of global-local processing in autism spectrum disorders (ASDs) have indicated mixed findings, with some evidence of a local processing bias, or preference for detail-level information, and other results suggesting typical global advantage, or preference for the whole or gestalt. Findings resulting from this paradigm have been used to argue for or against a detail focused processing bias in ASDs, and thus have important theoretical implications. We applied Systems Factorial Technology, and the associated Double Factorial Paradigm (both defined in the text), to examine information processing characteristics during a divided attention global-local task in high-functioning individuals with an ASD and typically developing controls. Group data revealed global advantage for both groups, contrary to some current theories of ASDs. Information processing models applied to each participant revealed that task performance, although showing no differences at the group level, was supported by different cognitive mechanisms in ASD participants compared to controls. All control participants demonstrated inhibitory parallel processing and the majority demonstrated a minimum-time stopping rule. In contrast, ASD participants showed exhaustive parallel processing with mild facilitatory interactions between global and local information. Thus our results indicate fundamental differences in the stopping rules and channel dependencies in individuals with an ASD.

  10. Insights into gait disorders: walking variability using phase plot analysis, Huntington's disease.

    Science.gov (United States)

    Collett, Johnny; Esser, Patrick; Khalil, Hanan; Busse, Monica; Quinn, Lori; DeBono, Katy; Rosser, Anne; Nemeth, Andrea H; Dawes, Helen

    2014-09-01

    Huntington's disease (HD) is a progressive inherited neurodegenerative disorder. Identifying sensitive methodologies to quantitatively measure early motor changes have been difficult to develop. This exploratory observational study investigated gait variability and symmetry in HD using phase plot analysis. We measured the walking of 22 controls and 35 HD gene carriers (7 premanifest (PreHD)), 16 early/mid (HD1) and 12 late stage (HD2) in Oxford and Cardiff, UK. The unified Huntington's disease rating scale-total motor scores (UHDRS-TMS) and disease burden scores (DBS) were used to quantify disease severity. Data was collected during a clinical walk test (8.8 or 10 m) using an inertial measurement unit attached to the trunk. The 6 middle strides were used to calculate gait variability determined by spatiotemporal parameters (co-efficient of variation (CoV)) and phase plot analysis. Phase plots considered the variability in consecutive wave forms from vertical movement and were quantified by SDA (spatiotemporal variability), SDB (temporal variability), ratio ∀ (ratio SDA:SDB) and Δangleβ (symmetry). Step time CoV was greater in manifest HD (p0.05). Phase plot analysis identified differences between manifest HD and controls for SDB, Ratio ∀ and Δangle (all pplot analysis may be a sensitive method of detecting gait changes in HD and can be performed quickly during clinical walking tests. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Intellectual Development in Autism Spectrum Disorders: New Insights from Longitudinal Studies

    Directory of Open Access Journals (Sweden)

    Giacomo eVivanti

    2013-07-01

    Full Text Available The presence/absence of Intellectual Disability (ID is considered to be the most critical factor affecting outcomes in individuals with Autism Spectrum Disorders (ASD. However, the question of the specific nature of ID in ASD has received little attention, with the current view being that ID is a co-morbid condition (i.e., one that is unrelated in etiology and causality from the ASD itself. Recent advances in developmental neuroscience, highlighting the importance of early exposure to social experiences for cognitive development, support an alternative view; that ID in ASD might emerge as a consequence of severe social-communication deficits on the experience-dependent mechanisms underlying neurocognitive development. We tested this prediction in two independent samples of young children with ASD (Ns=23 and 60, finding that children with greater ASD severity at an initial assessment were more likely to present with poorer cognitive outcomes at a later assessment, irrespective of initial cognitive level. These results suggest that ASD symptom severity contributes to the extent to which the environmental input required to support ‘typical’ brain development can be processed by the individual, so that the risk of developing ID increases as the number and severity of ASD social-communicative impairments increase.

  12. JAKE® Multimodal Data Capture System: Insights from an Observational Study of Autism Spectrum Disorder.

    Science.gov (United States)

    Ness, Seth L; Manyakov, Nikolay V; Bangerter, Abigail; Lewin, David; Jagannatha, Shyla; Boice, Matthew; Skalkin, Andrew; Dawson, Geraldine; Janvier, Yvette M; Goodwin, Matthew S; Hendren, Robert; Leventhal, Bennett; Shic, Frederick; Cioccia, Walter; Pandina, Gahan

    2017-01-01

    Objective: To test usability and optimize the Janssen Autism Knowledge Engine (JAKE®) system's components, biosensors, and procedures used for objective measurement of core and associated symptoms of autism spectrum disorder (ASD) in clinical trials. Methods: A prospective, observational study of 29 children and adolescents with ASD using the JAKE system was conducted at three sites in the United States. This study was designed to establish the feasibility of the JAKE system and to learn practical aspects of its implementation. In addition to information collected by web and mobile components, wearable biosensor data were collected both continuously in natural settings and periodically during a battery of experimental tasks administered in laboratory settings. This study is registered at clinicaltrials.gov, NCT02299700. Results: Feedback collected throughout the study allowed future refinements to be planned for all components of the system. The Autism Behavior Inventory (ABI), a parent-reported measure of ASD core and associated symptoms, performed well. Among biosensors studied, the eye-tracker, sleep monitor, and electrocardiogram were shown to capture high quality data, whereas wireless electroencephalography was difficult to use due to its form factor. On an exit survey, the majority of parents rated their overall reaction to JAKE as positive/very positive. No significant device-related events were reported in the study. Conclusion: The results of this study, with the described changes, demonstrate that the JAKE system is a viable, useful, and safe platform for use in clinical trials of ASD, justifying larger validation and deployment studies of the optimized system.

  13. Spatial Impairment and Memory in Genetic Disorders: Insights from Mouse Models

    Directory of Open Access Journals (Sweden)

    Sang Ah Lee

    2017-02-01

    Full Text Available Research across the cognitive and brain sciences has begun to elucidate some of the processes that guide navigation and spatial memory. Boundary geometry and featural landmarks are two distinct classes of environmental cues that have dissociable neural correlates in spatial representation and follow different patterns of learning. Consequently, spatial navigation depends both on the type of cue available and on the type of learning provided. We investigated this interaction between spatial representation and memory by administering two different tasks (working memory, reference memory using two different environmental cues (rectangular geometry, striped landmark in mouse models of human genetic disorders: Prader-Willi syndrome (PWScrm+/p− mice, n = 12 and Beta-catenin mutation (Thr653Lys-substituted mice, n = 12. This exploratory study provides suggestive evidence that these models exhibit different abilities and impairments in navigating by boundary geometry and featural landmarks, depending on the type of memory task administered. We discuss these data in light of the specific deficits in cognitive and brain function in these human syndromes and their animal model counterparts.

  14. Linking Mitochondria to Synapses: New Insights for Stress-Related Neuropsychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Freddy Jeanneteau

    2016-01-01

    Full Text Available The brain evolved cellular mechanisms for adapting synaptic function to energy supply. This is particularly evident when homeostasis is challenged by stress. Signaling loops between the mitochondria and synapses scale neuronal connectivity with bioenergetics capacity. A biphasic “inverted U shape” response to the stress hormone glucocorticoids is demonstrated in mitochondria and at synapses, modulating neural plasticity and physiological responses. Low dose enhances neurotransmission, synaptic growth, mitochondrial functions, learning, and memory whereas chronic, higher doses produce inhibition of these functions. The range of physiological effects by stress and glucocorticoid depends on the dose, duration, and context at exposure. These criteria are met by neuronal activity and the circadian, stress-sensitive and ultradian, stress-insensitive modes of glucocorticoid secretion. A major hallmark of stress-related neuropsychiatric disorders is the disrupted glucocorticoid rhythms and tissue resistance to signaling with the glucocorticoid receptor (GR. GR resistance could result from the loss of context-dependent glucocorticoid signaling mediated by the downregulation of the activity-dependent neurotrophin BDNF. The coincidence of BDNF and GR signaling changes glucocorticoid signaling output with consequences on mitochondrial respiration efficiency, synaptic plasticity, and adaptive trajectories.

  15. The difficult relationship between occlusal interferences and temporomandibular disorder - insights from animal and human experimental studies.

    Science.gov (United States)

    Xie, Q; Li, X; Xu, X

    2013-04-01

    The aetiology of temporomandibular disorder (TMD) is multifactorial, and numerous studies have addressed that occlusion may be of great importance. However, whether occlusion plays a crucial role in the pathogenesis of TMD remains controversial. Study designs utilising animal models have been used to study the effects of artificial occlusal alterations. Experimental traumatic occlusion affects blood flow in the temporomandibular joint and results in changes in the condylar cartilage, and artificial occlusal interference induces masticatory muscle nociceptive responses that are associated with peripheral sensitisation and lead to central sensitisation, which maintains masticatory muscle hyperalgesia. The possibility that occlusal interference results in TMD has been investigated in humans using a double-blind randomised design. Subjects without a history of TMD show fairly good adaptation to interferences. In contrast, subjects with a history of TMD develop a significant increase in clinical signs and self-report stronger symptoms (occlusal discomfort and chewing difficulties) in response to interferences. Meanwhile, psychological factors appear meaningful for symptomatic responses to artificial interferences in subjects with a history of TMD. Thus, individual differences in vulnerability to occlusal interferences do exist. Although there are advantages and disadvantages to using human and animal occlusal interference models, these approaches are indispensable for discovering the role of occlusion in TMD pathogenesis. © 2013 Blackwell Publishing Ltd.

  16. Witnessing traumatic events and post-traumatic stress disorder: Insights from an animal model.

    Science.gov (United States)

    Patki, Gaurav; Salvi, Ankita; Liu, Hesong; Salim, Samina

    2015-07-23

    It is becoming increasingly recognized that post-traumatic stress disorder (PTSD) can be acquired vicariously from witnessing traumatic events. Recently, we published an animal model called the "Trauma witness model" (TWM) which mimics PTSD-like symptoms in rats from witnessing daily traumatic events (social defeat of cage mate) [14]. Our TWM does not result in any physical injury. This is a major procedural advantage over the typical intruder paradigm in which it is difficult to delineate the inflammatory response of tissue injury and the response elicited from emotional distress. Using TWM paradigm, we examined behavioral and cognitive effects in rats [14] however, the long-term persistence of PTSD-like symptoms or a time-course of these events (anxiety and depression-like behaviors and cognitive deficits) and the contribution of olfactory and auditory stress vs visual reinforcement were not examined. This study demonstrates that some of the features of PTSD-like symptoms in rats are reversible after a significant time lapse of the witnessing of traumatic events. We also have established that witnessing is critical to the PTSD-like phenotype and cannot be acquired solely due to auditory or olfactory stresses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Disordered eating, amenorrhea, and substance use and misuse among professional ballet dancers: Preliminary analysis.

    Science.gov (United States)

    Peric, Mia; Zenic, Natasa; Sekulic, Damir; Kondric, Miran; Zaletel, Petra

    2016-01-01

    Substance use and misuse (SUM), eating disorders (ED) and consequent amenorrhea (AM) occur frequently in professional ballet dancing. The objective of this study has been to explore the prevalence and association between ED, AM and SUM in ballet. The sample comprised 21 ballet dancers, 23.1±4.5 years old, members of the professional National Ballet Ensemble from Croatia. Variables were collected by questionnaires examining SUM, occurrence of amenorrhea, and corresponding ballet-specific and socio-demographic factors (Questionnaire on Substance Use - QSU) and the level of ED (Brief Eating Disorder in Athletes Questionnaire - BEDA-Q). Smoking is prevalent in 40% of dancers (25% smoke on a daily basis), 36% often use analgesics, and 25% engage in binge drinking at least once a month. Smoking and binge drinking are less frequent in ballerinas with a higher academic level (r = 0.60 and r = 0.54 for binge drinking and smoking, respectively; p ballet should target dancers who consume alcohol to a greater extent. Future studies should specifically explore the less frequent consumption of analgesics among dancers who consume nutritional supplements. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  18. Insight from Mitochondrial Functions and Proteomics to Understand Cardiometabolic Disorders in Survivors of Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Leahy, Jade; Spahis, Schohraya; Bonneil, Eric; Garofalo, Carole; Grimard, Guy; Morel, Sophia; Laverdière, Caroline; Krajinovic, Maja; Drouin, Simon; Delvin, Edgard; Sinnett, Daniel; Marcil, Valérie; Levy, Emile

    2018-03-18

    Childhood acute lymphoblastic leukemia (cALL) is the most prevalent form of cancer in children. Due to advances in treatment and therapy, young cALL subjects now achieve a 90% survival rate. However, this tremendous advance does not come without consequence since ~2/3 of cALL survivors are affected by long-term and late, severe complications. Although the metabolic syndrome is a very serious sequel of cALL, the mechanisms remain undefined. It is also surprising to note that the mitochondrion, a central organelle in metabolic functions and the main cellular energy generator, have not yet been explored. To determine whether cALL survivors exhibit impairments in their mitochondrial functions and proteomic profiling in relationship with metabolic disorders in cALL survivors compared to healthy controls. Anthropometric measures, metabolic characteristics and lipid profiles were assessed, mitochondria isolated from peripheral blood mononuclear cells, and proteomic analyzed. Our data demonstrated that metabolically Unhealthy survivors exhibited several metabolic syndrome components (e.g. overweight, insulin resistance, dyslipidemia, inflammation) whereas Healthy cALL survivors resemble the Controls. In line with these abnormalities, functional experiments in these subjects revealed a significant decrease in the protein expression of mitochondrial antioxidant superoxide dismutase, PGC1-α transcription factor (a key modulator of mitochondrion biogenesis), and an increase in pro-apoptotic cytochrome c. Proteomic analysis of mitochondria by mass spectrometry revealed changes in the regulation of proteins related to inflammation, apoptosis, energy production, redox and antioxidant activity, fatty acid β-oxidation, protein transport and metabolism, and signalling pathways between groups. Through the use of proteomic analysis, our work demonstrated a number of significant alterations in protein expression in mitochondria of cALL survivors, especially the metabolically

  19. JAKE® Multimodal Data Capture System: Insights from an Observational Study of Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Seth L. Ness

    2017-09-01

    Full Text Available Objective: To test usability and optimize the Janssen Autism Knowledge Engine (JAKE® system's components, biosensors, and procedures used for objective measurement of core and associated symptoms of autism spectrum disorder (ASD in clinical trials.Methods: A prospective, observational study of 29 children and adolescents with ASD using the JAKE system was conducted at three sites in the United States. This study was designed to establish the feasibility of the JAKE system and to learn practical aspects of its implementation. In addition to information collected by web and mobile components, wearable biosensor data were collected both continuously in natural settings and periodically during a battery of experimental tasks administered in laboratory settings. This study is registered at clinicaltrials.gov, NCT02299700.Results: Feedback collected throughout the study allowed future refinements to be planned for all components of the system. The Autism Behavior Inventory (ABI, a parent-reported measure of ASD core and associated symptoms, performed well. Among biosensors studied, the eye-tracker, sleep monitor, and electrocardiogram were shown to capture high quality data, whereas wireless electroencephalography was difficult to use due to its form factor. On an exit survey, the majority of parents rated their overall reaction to JAKE as positive/very positive. No significant device-related events were reported in the study.Conclusion: The results of this study, with the described changes, demonstrate that the JAKE system is a viable, useful, and safe platform for use in clinical trials of ASD, justifying larger validation and deployment studies of the optimized system.

  20. Perfil cognitivo de pacientes con trastorno obsesivo compulsivo: resultados preliminares Cognitive Profile Of Obsessive-Compulsive Disorder Patients: Preliminary Data

    Directory of Open Access Journals (Sweden)

    Ricardo Rodríguez Biglieri

    2008-12-01

    Full Text Available El artículo presenta resultados preliminares de una tesis doctoral, desarrollada en el marco de una beca del CONICET, cuyo objetivo es evaluar el perfil cognitivo de pacientes con Trastorno Obsesivo Compulsivo (TOC. El Cuestionario de Creencias Obsesivas y la Escala de Fusión Pensamiento Acción fueron administrados a 28 pacientes TOC; 30 con otros cuadros de ansiedad (CA; y 32 controles comunitarios (CC. Este último grupo presentó puntuaciones más bajas en todas las creencias examinadas. El grupo TOC, comparado con el CA, registró en mayor grado creencias sobre responsabilidad por daño, sobrestimación de peligro, importancia de los pensamientos intrusivos y necesidad de controlarlos, y creencias de tipo moral y de daño a terceros. Ambos grupos no difirieron en las creencias sobre perfeccionismo y necesidad de certeza, y en las probabilísticas sobre daño a sí mismo; las cuales podrían considerarse factores comunes a varios cuadros de ansiedad y no específicos del TOC.The article presents preliminary findings from a doctoral thesis framework assessing the cognitive profile of Obsessive Compulsive Disorder (OCD patients. The Obsessive Belief Questionnaire and the Thought-Action Fusion Scale were completed by 30 obsessive-compulsive disorder patients (OCD, 30 patients with other anxiety disorders (AC, and 32 community controls (CC. The comparisons showed that CC group had signifi- cantly lower scores than both AC and CC groups in all variables evaluated. The OCD group had significantly higher scores than AC in importance and control of intrusive thoughts, responsibility for harm, overestimation of threat, and in moral and likelihood for events happening to other people components of thought-action fusion (TAF beliefs. There were not statistically differences between OCD and AC groups in perfectionism and need for certainty, and in likelihood for events happening to oneself component of TAF beliefs. Therefore, these later beliefs could

  1. Reliability of the Dissociative Trance Disorder Interview Schedule: A preliminary report.

    Science.gov (United States)

    Ross, Colin A; Somer, Eli; Goode, Caitlin

    2018-01-01

    One hundred inpatients in a hospital-based Trauma Program in the USA were interviewed with the Dissociative Trance Disorder Interview Schedule (DTDIS). There were no significant differences for the DTDIS total score or any of the subscale scores on test-retest: all t-values comparing the two administrations of the DTDIS were below 0.7, and all p-values were above 0.5. Cronbach's alpha for the US sample was 0.966 and for the Israeli sample it was 0.971. The findings indicate that the DTDIS has good reliability and may be suitable for use in cross-cultural research; however, the results require replication by independent researchers in a variety of cultures and languages, and in both clinical and nonclinical samples.

  2. Efficacy of Low-Dose Protocol in Follow-Up of Lymphoproliferative Disorders - Preliminary Results

    International Nuclear Information System (INIS)

    Popic-Ramac, J.; Brnic, Z.; Klasic, B.; Hebrang, A.; Knezevic, Z.

    2011-01-01

    Most medically-related radiation is caused by diagnostic examinations, in particular by computed tomography (CT). The purpose of this research is to reduce radiation doses faced by the population frequently exposed to such procedures-those with lymphoproliferative disorders. The research was conducted comparing radiation-exposition doses received by the radiosensitive organs (thyroid, lens, breast and gonad) using the standard thoracic CT protocol with the radiation received using the low-dose protocol, while maintaining display quality. The standard-dose thoracic protocol implies 120 kV and 150 mAs. The low-dose protocol was conducted on the same device using 120 kV and 30 mAs. We confirmed the hypothesis that the use of the low-dose thoracic CT protocol leads to a reduction in radiation dose without compromising display quality. It is further expected that a reduction in doses will reduce the risk of radiation-related mutations. (author)

  3. Orthostatic Tremor and Orthostatic Myoclonus: Weight-bearing Hyperkinetic Disorders: A Systematic Review, New Insights, and Unresolved Questions

    Directory of Open Access Journals (Sweden)

    Anhar Hassan

    2016-11-01

    Full Text Available Background: Orthostatic tremor (OT and orthostatic myoclonus (OM are weight-bearing hyperkinetic movement disorders most commonly affecting older people that induce “shaky legs” upon standing. OT is divided into “classical” and “slow” forms based on tremor frequency. In this paper, the first joint review of OT and OM, we review the literature and compare and contrast their demographic, clinical, electrophysiological, neuroimaging, pathophysiological, and treatment characteristics. Methods: A PubMed search up to July 2016 using the phrases “orthostatic tremor,” “orthostatic myoclonus,” “shaky legs,” and “shaky legs syndrome” was performed. Results: OT and OM should be suspected in older patients reporting unsteadiness with prolonged standing and/or who exhibit cautious, wide-based gaits. Surface electromyography (SEMG is necessary to verify the diagnoses. Functional neuroimaging and electrophysiology suggest the generator of classical OT lies within the cerebellothalamocortical network. For OM, and possibly slow OT, the frontal, subcortical cerebrum is the most likely origin. Clonazepam is the most useful medication for classical OT, and levetiracetam for OM, although results are often disappointing. Deep brain stimulation appears promising for classical OT. Rolling walkers reliably improve gait affected by these disorders, as both OT and OM attenuate when weight is transferred from the legs to the arms. Discussion: Orthostatic hyperkinesias are likely underdiagnosed, as SEMG is often unavailable in clinical practice, and thus may be more frequent than currently recognized. The shared weight-bearing induction of OT and OM may indicate a common pathophysiology. Further research, including use of animal models, is necessary to better define the prevalence and pathophysiology of OT and OM, in order to improve their treatment, and provide additional insights into basic balance and gait mechanisms.

  4. Disordered eating, amenorrhea, and substance use and misuse among professional ballet dancers: Preliminary analysis

    Directory of Open Access Journals (Sweden)

    Mia Peric

    2016-04-01

    Full Text Available Background: Substance use and misuse (SUM, eating disorders (ED and consequent amenorrhea (AM occur frequently in professional ballet dancing. The objective of this study has been to explore the prevalence and association between ED, AM and SUM in ballet. Material and Methods: The sample comprised 21 ballet dancers, 23.1±4.5 years old, members of the professional National Ballet Ensemble from Croatia. Variables were collected by questionnaires examining SUM, occurrence of amenorrhea, and corresponding ballet-specific and socio-demographic factors (Questionnaire on Substance Use – QSU and the level of ED (Brief Eating Disorder in Athletes Questionnaire – BEDA-Q. Results: Smoking is prevalent in 40% of dancers (25% smoke on a daily basis, 36% often use analgesics, and 25% engage in binge drinking at least once a month. Smoking and binge drinking are less frequent in ballerinas with a higher academic level (r = 0.60 and r = 0.54 for binge drinking and smoking, respectively; p < 0.05. Alcohol drinking is higher among dancers who consume analgesics more often and those with a higher BEDA-Q score (r = 0.53 and r = 0.54 for analgesics and BEDA-Q, respectively; p < 0.05. Amenorrhea is more prevalent among those dancers with a higher BEDA-Q score. Women who consume nutritional supplements are less likely to use analgesics (Mann Whitney U test = 2.11; p < 0.05. Conclusions: Efforts seeking to prevent ED in ballet should target dancers who consume alcohol to a greater extent. Future studies should specifically explore the less frequent consumption of analgesics among dancers who consume nutritional supplements. Med Pr 2016;67(1:21–27

  5. Effects of body mass index-related disorders on cognition: preliminary results

    Directory of Open Access Journals (Sweden)

    Yesavage JA

    2014-05-01

    Full Text Available Jerome A Yesavage,1,2 Lisa M Kinoshita,1,2 Art Noda,2 Laura C Lazzeroni,2 Jennifer Kaci Fairchild,1,2 Joy Taylor,1,2 Doina Kulick,3 Leah Friedman,1,2 Jauhtai Cheng,1,2 Jamie M Zeitzer,1,2 Ruth O’Hara1,21Department of Veterans Affairs Health Care System, Palo Alto, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; 3Department of Medicine, University of Nevada School of Medicine, Reno, NV, USABackground: Well-known risk factors for cognitive impairment are also associated with obesity. Research has highlighted genetic risk factors for obesity, yet the relationship of those risk factors with cognitive impairment is unknown. The objective of this study was to determine the associations between cognition, hypertension, diabetes, sleep-disordered breathing, and obesity. Genetic risk factors of obesity were also examined.Methods: The sample consisted of 369 nondemented individuals aged 50 years or older from four community cohorts. Primary outcome measures included auditory verbal memory, as measured by the Rey Auditory Verbal Learning Test, and executive functioning, as measured by the Color–Word Interference Test of the Delis–Kaplan Executive Function System battery. Apnea–hypopnea index indicators were determined during standard overnight polysomnography. Statistical analyses included Pearson correlations and linear regressions.Results: Poor executive function and auditory verbal memory were linked to cardiovascular risk factors, but not directly to obesity. Genetic factors appeared to have a small but measureable association to obesity.Conclusion: A direct linkage between obesity and poor executive function and auditory verbal memory is difficult to discern, possibly because nonobese individuals may show cognitive impairment due to insulin resistance and the “metabolic syndrome”.Keywords: sleep-disordered breathing, hypertension, diabetes, sleep apnea, BMI, obesity

  6. Sweet taste preference in binge-eating disorder: A preliminary investigation.

    Science.gov (United States)

    Goodman, Erica L; Breithaupt, Lauren; Watson, Hunna J; Peat, Christine M; Baker, Jessica H; Bulik, Cynthia M; Brownley, Kimberly A

    2018-01-01

    Research suggests that individuals with high liking for sweets are at increased risk for binge eating, which has been minimally investigated in individuals with binge-eating disorder (BED). Forty-one adults (85% female, 83% white) with binge eating concerns completed a sweet taste test and measures of eating disorder behaviors and food cravings. A subset of participants with BED completed an oral glucose tolerance test (OGTT; N=21) and a 24-hour dietary recall (N=26). Regression models were used to compare highest sweet preferers (HSP [N=18]) to other sweet preferers (OSP [N=23]) and were used to assess associations between sweet taste preference and outcome variables. Effect sizes (ηp 2 ) for differences between HSP and OSP ranged from small (≤0.01) to large (≥0.24); group differences were statistically nonsignificant except for 24-hour caloric intake (ηp 2 =0.16, p=0.04), protein intake (ηp 2 =0.16, p=0.04), and insulin sensitivity index (ηp 2 =0.24, p=0.04), which were higher in HSP, and postprandial insulin, which was smaller in HSP (ηp 2 =0.27, p=0.03). Continuous analyses replicated postprandial insulin response. Compared with OSP, HSP reported numerically higher binge-eating frequency (ηp 2 =0.04), over-eating frequency (ηp 2 =0.06), and carbohydrate intake (ηp 2 =0.14), and they exhibited numerically smaller postprandial glucose AUC (ηp 2 =0.16). Sweet taste preference may have implications for glucose regulation, binge-eating frequency, and nutrient intake in BED. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. A preliminary investigation of sleep quality in functional neurological disorders: Poor sleep appears common, and is associated with functional impairment.

    Science.gov (United States)

    Graham, Christopher D; Kyle, Simon D

    2017-07-15

    Functional neurological disorders (FND) are disabling conditions for which there are few empirically-supported treatments. Disturbed sleep appears to be part of the FND context; however, the clinical importance of sleep disturbance (extent, characteristics and impact) remains largely unknown. We described sleep quality in two samples, and investigated the relationship between sleep and FND-related functional impairment. We included a sample recruited online via patient charities (N=205) and a consecutive clinical sample (N=20). Participants completed validated measures of sleep quality and sleep characteristics (e.g. total sleep time, sleep efficiency), mood, and FND-related functional impairment. Poor sleep was common in both samples (89% in the clinical range), which was characterised by low sleep efficiency (M=65.40%) and low total sleep time (M=6.05h). In regression analysis, sleep quality was negatively associated with FND-related functional impairment, accounting for 16% of the variance and remaining significant after the introduction of mood variables. These preliminary analyses suggest that subjective sleep disturbance (low efficiency, short sleep) is common in FND. Sleep quality was negatively associated with the functional impairment attributed to FND, independent of depression. Therefore, sleep disturbance may be a clinically important feature of FND. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Cognitive-behavioral therapy plus motivational interviewing improves outcome for pediatric obsessive-compulsive disorder: A preliminary study

    Science.gov (United States)

    Merlo, Lisa J.; Storch, Eric A.; Lehmkuhl, Heather D.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.

    2010-01-01

    Lack of motivation may negatively impact cognitive behavioral therapy (CBT) response for pediatric patients with obsessive-compulsive disorder (OCD). Motivational interviewing is a method for interacting with patients in order to decrease their ambivalence and support their self-efficacy in their efforts at behavior change. This paper presents a preliminary randomized trial (N = 16) to evaluate the effectiveness of adding motivational interviewing (MI) as an adjunct to CBT. Patients aged 6–17 who were participating in intensive family-based CBT for OCD were randomized to receive either CBT plus MI or CBT plus extra psychoeducation sessions. Results indicated that after 4 sessions, the mean CY-BOCS score for the CBT+MI group was significantly lower than for the CBT+psychoeducation group (t(14) = 2.51, p < .03, Cohen’s d = 1.34). In addition, the degree of reduction in CY-BOCS scores was significantly greater (t(14) = 2.14, p = .05, Cohen’s d = 1.02) for the CBT+MI group (mean change = 16.75, SD = 9.66) than for the CBT+psychoeducation group (mean change = 8.13, SD = 6.01). This effect decreased over time, and scores at post-treatment were not significantly different. However, participants in the MI group completed treatment on average three sessions earlier than those in the psychoeducation group, providing support for the utility of MI in facilitating rapid improvement and minimizing the burden of treatment for families. PMID:19675960

  9. A Preliminary Study of the Influence of Age of Onset and Childhood Trauma on Cortical Thickness in Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Natalia Jaworska

    2014-01-01

    Full Text Available Background. Major depressive disorder (MDD neural underpinnings may differ based on onset age and childhood trauma. We assessed cortical thickness in patients who differed in age of MDD onset and examined trauma history influence. Methods. Adults with MDD (N=36 and controls (HC; N=18 underwent magnetic resonance imaging. Twenty patients had MDD onset 25 years of age (adult onset. The MDD group was also subdivided into those with (N=12 and without (N=19 physical and/or sexual abuse as assessed by the Childhood Trauma Questionnaire (CTQ. Cortical thickness was analyzed with FreeSurfer software. Results. Thicker frontal pole and a tendency for thinner transverse temporal cortices existed in MDD. The former was driven by the pediatric onset group and abuse history (independently, particularly in the right frontal pole. Inverse correlations existed between CTQ scores and frontal pole cortex thickness. A similar inverse relation existed with left inferior and right superior parietal cortex thickness. The superior temporal cortex tended to be thinner in pediatric versus adult onset groups with childhood abuse. Conclusions. This preliminary work suggests neural differences between pediatric and adult MDD onset. Trauma history also contributes to cytoarchitectural modulation. Thickened frontal pole cortices as a compensatory mechanism in MDD warrant evaluation.

  10. Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study

    Science.gov (United States)

    Ruocco, Anthony C.; Rodrigo, Achala H.; McMain, Shelley F.; Page-Gould, Elizabeth; Ayaz, Hasan; Links, Paul S.

    2016-01-01

    Self-harm is a potentially lethal symptom of borderline personality disorder (BPD) that often improves with dialectical behavior therapy (DBT). While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, 29 actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex (PFC) during impulse control prior to beginning DBT and after 7 months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex (DLPFC) prior to beginning treatment, and they showed the greatest increases in activity within this region after 7 months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial PFC and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right DLPFC even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the PFC underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT. PMID:27242484

  11. Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results.

    Science.gov (United States)

    Feliu-Soler, Albert; Pascual, Juan C; Borràs, Xavier; Portella, Maria J; Martín-Blanco, Ana; Armario, Antonio; Alvarez, Enric; Pérez, Víctor; Soler, Joaquim

    2014-01-01

    Emotional dysregulation has been proposed as a hallmark of borderline personality disorder (BPD). Mindfulness techniques taught in dialectical behaviour therapy (DBT) appear to be effective in reducing affective symptoms and may enhance emotion regulation in BPD patients. In the present study, we assessed whether 10 weeks of DBT-mindfulness (DBT-M) training added to general psychiatric management (GPM) could improve emotion regulation in BPD patients. A total of 35 patients with BPD were included and sequentially assigned to GPM (n = 17) or GPM plus DBT-M (n = 18). Participants underwent a negative emotion induction procedure (presentation of standardized unpleasant images) both pre-intervention and post-intervention. Clinical evaluation was also performed before and after treatment. No differences were observed in emotional response at the post-treatment session. However, patients in the DBT-M group showed greater improvement in clinical symptoms. Formal mindfulness practice was positively correlated with clinical improvements and lower self-reported emotional reactivity. Our preliminary results suggest that mindfulness training reduces some psychiatric symptoms but may not have a clear effect on how patients respond to emotional stimuli in an experimental setting. No clear effect of mindfulness training was observed on emotional response to a negative emotion induction procedure. Application of the DBT-M module jointly to GPM induced better clinical outcomes than GPM alone. Formal mindfulness practice showed a positive impact on emotion regulation and clinical improvement. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Anthony Charles Ruocco

    2016-05-01

    Full Text Available Self-harm is a potentially lethal symptom of borderline personality disorder (BPD that often improves with dialectical behavior therapy (DBT. While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, twenty-nine actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex during impulse control prior to beginning DBT and after seven months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex prior to beginning treatment, and they showed the greatest increases in activity within this region after seven months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial prefrontal cortex and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right dorsolateral prefrontal cortex even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the prefrontal cortex underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT.

  13. Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study.

    Science.gov (United States)

    Ruocco, Anthony C; Rodrigo, Achala H; McMain, Shelley F; Page-Gould, Elizabeth; Ayaz, Hasan; Links, Paul S

    2016-01-01

    Self-harm is a potentially lethal symptom of borderline personality disorder (BPD) that often improves with dialectical behavior therapy (DBT). While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, 29 actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex (PFC) during impulse control prior to beginning DBT and after 7 months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex (DLPFC) prior to beginning treatment, and they showed the greatest increases in activity within this region after 7 months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial PFC and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right DLPFC even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the PFC underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT.

  14. Preliminary evidence that different mechanisms underlie the anger superiority effect in children with and without Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Tomoko eIsomura

    2014-05-01

    Full Text Available Previous studies have demonstrated that angry faces capture humans’ attention more rapidly than emotionally positive faces. This phenomenon is referred to as the anger superiority effect (ASE. Despite atypical emotional processing, adults and children with Autism Spectrum Disorders (ASD have been reported to show ASE as well as typically developed (TD individuals. So far, however, few studies have clarified whether or not the mechanisms underlying ASE are the same for both TD and ASD individuals. Here, we tested how TD and ASD children process schematic emotional faces during detection by employing a recognition task in combination with a face-in-the-crowd task. Results of the face-in-the-crowd task revealed the prevalence of ASE both in TD and ASD children. However, the results of the recognition task revealed group differences: In TD children, detection of angry faces required more configural face processing and disrupted the processing of local features. In ASD children, on the other hand, it required more feature-based processing rather than configural processing. Despite the small sample sizes, these findings provide preliminary evidence that children with ASD, in contrast to TD children, show quick detection of angry faces by extracting local features in faces.

  15. Preliminary evidence of altered neural response during intertemporal choice of losses in adult attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Tanaka, Saori C; Yahata, Noriaki; Todokoro, Ayako; Kawakubo, Yuki; Kano, Yukiko; Nishimura, Yukika; Ishii-Takahashi, Ayaka; Ohtake, Fumio; Kasai, Kiyoto

    2018-04-30

    Impulsive behaviours are common symptoms of attention-deficit hyperactivity disorder (ADHD). Although previous studies have suggested functional models of impulsive behaviour, a full explanation of impulsivity in ADHD remains elusive. To investigate the detailed mechanisms behind impulsive behaviour in ADHD, we applied an economic intertemporal choice task involving gains and losses to adults with ADHD and healthy controls and measured brain activity by functional magnetic resonance imaging. In the intertemporal choice of future gains, we observed no behavioural or neural difference between the two groups. In the intertemporal choice of future losses, adults with ADHD exhibited higher discount rates than the control participants. Furthermore, a comparison of brain activity representing the sensitivity of future loss in the two groups revealed significantly lower activity in the striatum and higher activity in the amygdala in adults with ADHD than in controls. Our preliminary findings suggest that an altered size sensitivity to future loss is involved in apparent impulsive choice behaviour in adults with ADHD and shed light on the multifaceted impulsivity underlying ADHD.

  16. A Preliminary Investigation of Pathways to Inflated Responsibility Beliefs in Children with Obsessive Compulsive Disorder.

    Science.gov (United States)

    Collins, Lindsey M; Coles, Meredith E

    2018-05-01

    Cognitive theorists posit that inflated responsibility beliefs contribute to the development of obsessive compulsive disorder (OCD). Salkovskis et al. (1999) proposed that experiencing heightened responsibility, overprotective parents and rigid rules, and thinking one influenced or caused a negative life event act as 'pathways' to the development of inflated responsibility beliefs, thereby increasing risk for OCD. Studies in adults with OCD and non-clinical adolescents support the link between these experiences and responsibility beliefs (Coles et al., 2015; Halvaiepour and Nosratabadi, 2015), but the theory has never been tested in youth with current OCD. We provided an initial test of the theory by Salkovskis et al. (1999) in youth with OCD. We predicted that childhood experiences proposed by Salkovskis et al. (1999) would correlate positively with responsibility and harm beliefs and OCD symptom severity. Twenty youth with OCD (age 9‒16 years) completed a new child-report measure of the experiences hypothesized by Salkovskis et al. (1999), the Pathways to Inflated Responsibility Beliefs Scale-Child Version (PIRBS-CV). Youth also completed the Obsessive Beliefs Questionnaire-Child Version (Coles et al., 2010) and the Obsessive Compulsive Inventory-Child Version (Foa et al., 2010). Consistent with hypotheses, the PIRBS-CV was significantly related to responsibility and harm beliefs and OCD symptom severity. Results provide initial support for the theory proposed by Salkovskis et al. (1999) as applied to youth with OCD. Future studies are needed to further assess the model in early-onset OCD.

  17. Analysis of cognitive disorders in older people with diabetes – preliminary study

    Directory of Open Access Journals (Sweden)

    Aneta Kozieł

    2016-04-01

    Full Text Available Introduction : Diabetes is a growing public health problem. Epidemiological studies indicate that the disease shortens life and significantly deteriorates its quality. The impact of diabetes on physical health of patients is well documented, but its impact on cognitive abilities has not been studied in detail so far. The deficit of reports regarding this problem among Polish researchers was an inspiration to start new studies. Aim of the research: To evaluate mild cognitive disorders in elderly patients with diabetes. Material and methods: The study was conducted in 2015. The study group included 7 elderly people with type 2 diabetes for more than 10 years. The control group consisted of 7 individuals of the same age without diabetes. The research tool was a self-made questionnaire to examine the cognitive abilities. An analysis of cognitive functions such as short-term memory, performing analysis and synthesis processes, understanding and creating metaphorical examples, narration and performing metalinguistic operations was performed. Results : Differences in cognitive functioning in the field of the studied variables were observed between examined groups. Elderly people with diabetes achieved significantly lower scores in all examined cognitive functions than healthy respondents. Conclusions : Elderly patients with type 2 diabetes are particularly susceptible to mild cognitive impairment. It is necessary to take this group of patients under diagnosis and early secondary prevention in order to prevent the negative impact of the disease.

  18. Magnetic resonance imaging of the fetus in congenital intrathoracic disorders: preliminary observations

    Energy Technology Data Exchange (ETDEWEB)

    Liu Xiang; Ashtari, M.; Leonidas, J.C. [Dept. of Radiology, Schneider Children' s Hospital, Long Island Jewish Medical Center, NY (United States); Chan Ying [Fetal-Maternal Medicine, Schneider Children' s Hospital, Long Island Jewish Medical Center, and the Albert Einstein College of Medicine, NY (United States)

    2001-06-01

    Background and objective. Advances in magnetic resonance imaging (MRI) provide high-quality images of the intrathoracic organs. We studied the ability of MRI to define spatial relationships of the fetal lungs and measured lung volume in two cases of congenital diaphragmatic hernia (CDH), one of severe oligohydramnios secondary to bilateral cystic renal dysplasia and one case of prenatal chylothorax. Patients and methods. We performed pelvic MRI using single-shot fast spin echo (SSFSE) pulse sequence in four pregnant women referred because of abnormal prenatal ultrasound (US) findings associated with pulmonary hypoplasia. Results. The exact anatomic position of the contents of the hernia in CDH, including the position of the liver, was better defined with MRI. Pleural effusions were identified as well as the renal abnormality in the case of oligohydramnios. Lung volume was measured and the degree of pulmonary hypoplasia was quantified in every case. Lung-to-thorax ratio was calculated in the case of fetal chylothorax. Conclusion. Ongoing work suggests that MRI can provide additional detailed quantitative information in prenatal disorders associated with fetal lung compression and resulting hypoplasia. Correlation of fetal lung volume with postnatal management and outcome may affect prognosis in these cases. (orig.)

  19. Binge eating disorder and obesity: preliminary evidence for distinct cardiovascular and psychological phenotypes.

    Science.gov (United States)

    Klatzkin, Rebecca R; Gaffney, Sierra; Cyrus, Kathryn; Bigus, Elizabeth; Brownley, Kimberly A

    2015-04-01

    This study investigated cardiovascular functioning, mood, and eating-related psychological factors at rest and in response to mental stress in three groups of women: 1) Obese women with binge eating disorder (BED; n=9); 2) obese non-BED women (n=15); and 3) normal weight (NW) non-BED women (n=15). Compared to both obese and NW non-BED women, obese women with BED showed heightened overall blood pressure and reported greater depression symptoms, perceived stress, and eating-related psychopathology. Additionally, obese women with BED reported greater overall negative affect and state anxiety compared to obese non-BED women. The heart rate response to stress was blunted in the obese BED group compared to the other groups, but this effect was no longer significant after controlling for baseline differences in depression. Correlational analyses revealed a positive association between stress-induced changes in hunger and cardiovascular measures only in obese women with BED. Longitudinal studies are needed to determine if stress dysregulation and stress-induced increases in hunger contribute to the onset and/or maintenance of BED. In particular, studies utilizing an additional NW BED control group are warranted in order to further examine the impact of BED above and beyond the impact of obesity on psychophysiological functioning and to inform the growing literature regarding stress-related factors that distinguish the BED and obesity phenotypes. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Adaptation and Preliminary Testing of the Developmental Coordination Disorder Questionnaire (DCDQ) for Children in India.

    Science.gov (United States)

    Patel, Priya; Gabbard, Carl

    2017-05-01

    While Developmental Coordination Disorder (DCD) has gained worldwide attention, in India it is relatively unknown. The revised DCD Questionnaire (DCDQ'07) is one of the most utilized screening tools for DCD. The aim of this study was to translate the DCDQ'07 into the Hindi language (DCDQ-Hindi) and test its basic psychometric properties. The DCDQ'07 was translated following guidelines for cross cultural adaptation of instruments. Parents of 1100 children (5-15 years) completed the DCDQ-Hindi, of which 955 were considered for data analysis and 60 were retested randomly after 3 weeks for test-retest reliability. The DCDQ-Hindi showed high internal consistency (α = .86) and moderate test-retest reliability (.73). Confirmatory factor analysis showed equivalence to the DCDQ'07. The% probable DCD using DCDQ'07 cutoff scores (≤57) ranged from 22% to 68%. Using more stringent cutoffs (≤36) it ranged from 5% to 9%. Significant difference was seen for gender (p < .05) in subset 1(gross-motor skills) total scores. The DCDQ-Hindi reveals promise for initial identification of Hindi speaking Indian children with DCD. Based on more stringent cut-off scores, the "probable prevalence" of children with risk of DCD in India appears to be around 6-7%. Research with larger sample and comparison with the MABC-2 or equivalent is needed.

  1. Group cognitive behavior therapy for Japanese patients with social anxiety disorder: preliminary outcomes and their predictors

    Directory of Open Access Journals (Sweden)

    Watanabe Norio

    2007-12-01

    Full Text Available Abstract Background A number of studies have provided strong evidence for the use of cognitive behavior therapy (CBT in the treatment of social anxiety disorder (SAD. However, all of the previous reports were from Europe and North America and it is unknown whether Western psychological therapies are effective for SAD in non-Western cultures. The present pilot study aimed to evaluate CBT program for SAD which was originally developed for Western patients, among Japanese patients. Methods Fifty-seven outpatients who participated in group CBT for SAD were evaluated using eight self-reported and one clinician-administered questionnaires to measure various aspects of SAD symptomatology at the beginning and at the end of the program. Pre- and post-treatment scores were compared and the magnitude of treatment effect was quantified as well based once on the intention-to-treat (ITT and once among the completers only. We also examined baseline predictors of the CBT outcomes. Results Seven patients (12% did not complete the program. For the ITT sample, the percentage of reduction was 20% to 30% and the pre to post treatment effect sizes ranged from 0.37 to 1.01. Among the completers, the respective figures were 20% to 33% and 0.41 to 1.19. We found no significant pretreatment predictor of the outcomes. Conclusion Group CBT for SAD is acceptable and can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.

  2. Antisocial and Schizoid Personality Disorder Scales: Conceptual bases and preliminary findings

    Directory of Open Access Journals (Sweden)

    Octav - Sorin Căndel

    2017-06-01

    Full Text Available The study describes the development and validation of two scales which can be used in evaluating schizoid and antisocial personality disorders. Both scales were developed relying on descriptions from DSM 5 and ICD 10. For validation, the scales have been tested on 125 subjects, together with two well-known psychometric instruments, DA12profile Personality Inventory, and SCL-90. Internal consistency is calculated using Cronbach's alpha coefficient. Schizoid Scale contains 20 items and shows a good internal consistency (Cronbach's α = .77 and Antisocial Scale contains 22 items and has excellent internal consistency (Cronbach's α = .91. The correlations between the scores of the two scales and the scores of DA12profile Personality Inventory and SCL-90 are statistically significant. The factorial analysis reveals that the two scales and DA12profile Personality Inventory sub-scales are clustered in four factors, explaining 68.31 % of the variance. Based on these results, we discussed the importance the scales have for psychological research and for psycho-diagnostic, their limitations and our future directions of research.

  3. Magnetic resonance imaging of the fetus in congenital intrathoracic disorders: preliminary observations

    International Nuclear Information System (INIS)

    Liu Xiang; Ashtari, M.; Leonidas, J.C.; Chan Ying

    2001-01-01

    Background and objective. Advances in magnetic resonance imaging (MRI) provide high-quality images of the intrathoracic organs. We studied the ability of MRI to define spatial relationships of the fetal lungs and measured lung volume in two cases of congenital diaphragmatic hernia (CDH), one of severe oligohydramnios secondary to bilateral cystic renal dysplasia and one case of prenatal chylothorax. Patients and methods. We performed pelvic MRI using single-shot fast spin echo (SSFSE) pulse sequence in four pregnant women referred because of abnormal prenatal ultrasound (US) findings associated with pulmonary hypoplasia. Results. The exact anatomic position of the contents of the hernia in CDH, including the position of the liver, was better defined with MRI. Pleural effusions were identified as well as the renal abnormality in the case of oligohydramnios. Lung volume was measured and the degree of pulmonary hypoplasia was quantified in every case. Lung-to-thorax ratio was calculated in the case of fetal chylothorax. Conclusion. Ongoing work suggests that MRI can provide additional detailed quantitative information in prenatal disorders associated with fetal lung compression and resulting hypoplasia. Correlation of fetal lung volume with postnatal management and outcome may affect prognosis in these cases. (orig.)

  4. Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

    Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems...

  5. A randomized controlled trial of metacognitive therapy vs. cognitive behavioral therapy vs. waiting list in the treatment of adults with generalized anxiety disorder: A preliminary analysis

    OpenAIRE

    Kvistedal, Draco Jon Torstein

    2011-01-01

    Forty two participants with generalized anxiety disorder were treated with either Metacognitive therapy or Cognitive Behavioral Therapy, in a randomized controlled study comparing the relative effect of the two treatments. A wait list condition comprised the control group. Statistical analysis proved MCT superior to CBT, and CBT proved superior to no treatment. Because this is a preliminary study it has some limitations, such as no follow-up data or treatment adherence control. Thus at the cu...

  6. Resting-state functional connectivity between right anterior insula and right orbital frontal cortex correlate with insight level in obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Jie Fan

    2017-01-01

    Full Text Available Few studies have explored the neurobiological basis of insight level in obsessive-compulsive disorder (OCD, though the salience network (SN has been implicated in insight deficits in schizophrenia. This study was then designed to investigate whether resting-state (rs functional connectivity (FC of SN was associated with insight level in OCD patients. We analyzed rs-functional magnetic resonance imaging (fMRI data from 21 OCD patients with good insight (OCD-GI, 19 OCD patients with poor insight (OCD-PI, and 24 healthy controls (HCs. Seed-based whole-brain FC and ROI (region of interest-wise connectivity analyses were performed with seeds/ROIs in the bilateral anterior insula (AI and dorsal anterior cingulate cortex (dACC. The right AI-right medial orbital frontal cortex (mOFC connectivity was found to be uniquely decreased in the OCD-PI group, and the value of this aberrant connectivity correlated with insight level in OCD patients. In addition, we found that the OCD-GI group had significantly increased right AI-left dACC connectivity within the SN, relative to HCs (overall trend for groups: OCD-GI > OCD-PI > HC. Our findings suggest that abnormal right AI-right mOFC FC may mediate insight deficits in OCD, perhaps due to impaired encoding and integration of self-evaluative information about OCD-related beliefs and behaviors. Our findings indicate a SN connectivity dissociation between OCD-GI and OCD-PI patients and support the notion of considering OCD-GI and OCD-PI as two distinct disorder subtypes.

  7. Effects of technological learning and uranium price on nuclear cost: Preliminary insights from a multiple factors learning curve and uranium market modeling

    International Nuclear Information System (INIS)

    Kahouli, Sondes

    2011-01-01

    This paper studies the effects of returns to scale, technological learning, i.e. learning-by-doing and learning-by-searching, and uranium price on the prospects of nuclear cost decrease. We use an extended learning curve specification, named multiple factors learning curve (MFLC). In a first stage, we estimate a single MFLC. In a second stage, we estimate the MFLC under the framework of simultaneous system of equations which takes into account the uranium supply and demand. This permits not only to enhance the reliability of the estimation by incorporating the uranium price formation mechanisms in the MFLC via the price variable, but also to give preliminary insights about uranium supply and demand behaviors and the associated effects on the nuclear expansion. Results point out that the nuclear cost has important prospects for decrease via capacity expansion, i.e. learning-by-doing effects. In contrast, they show that the learning-by-searching as well as the scale effects have a limited effect on the cost decrease prospects. Conversely, results also show that uranium price exerts a positive and significant effect on nuclear cost, implying that when the uranium price increases, the nuclear power generation cost decreases. Since uranium is characterized by important physical availability, and since it represents only a minor part in the total nuclear cost, we consider that in a context of increasing demand for nuclear energy the latter result can be explained by the fact that the positive learning effects on the cost of nuclear act in a way to dissipate the negative ones that an increase in uranium price may exert. Further, results give evidence of important inertia in the supply and demand sides as well as evidence of slow correlation between the uranium market and oil market which may limit the inter-fuels substituability effects, that is, nuclear capacity expansion and associated learning-by-doing benefits. - Highlights: → We study the prospects of nuclear cost

  8. (Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance.

    Science.gov (United States)

    Meyer, Lene Bomholt; Waaddegaard, Mette; Lau, Marianne Engelbrecht; Tjørnhøj-Thomsen, Tine

    2018-04-01

    Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark. The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others. Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.

  9. High prevalence of bipolar disorder comorbidity in adolescents and young adults with high-functioning autism spectrum disorder: a preliminary study of 44 outpatients.

    Science.gov (United States)

    Munesue, T; Ono, Y; Mutoh, K; Shimoda, K; Nakatani, H; Kikuchi, M

    2008-12-01

    Psychiatric comorbidity of autism spectrum disorder (ASD) has not been well examined. Mood disorders in 44 consecutive outpatients with high-functioning ASD were examined at a university hospital according to DSM-IV. Inclusion criteria were an IQ of 70 or higher on the Wechsler Intelligence Scale and age of 12 years or over. Sixteen patients (36.4%) were diagnosed with mood disorder. Of these 16 patients, four were diagnosed as having major depressive disorder, two patients as bipolar I disorder, six patients as bipolar II disorder, and four patients as bipolar disorder not otherwise specified. Bipolar disorder accounted for 75% of cases. Twelve patients had Asperger disorder and four patients had pervasive developmental disorder not otherwise specified. None of the patients had autistic disorder. The sample size was small. We could not use Autism Diagnostic Interview - Revised. Referral bias could not be avoided in this study. The major comorbid mood disorder in patients with high-functioning ASD is bipolar disorder and not major depressive disorder. The autistic spectrum may share common vulnerability genes with the bipolar spectrum.

  10. Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments.

    Science.gov (United States)

    Lysaker, Paul H; Pattison, Michelle L; Leonhardt, Bethany L; Phelps, Scott; Vohs, Jenifer L

    2018-02-01

    Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture. © 2018 World Psychiatric Association.

  11. A Preliminary Core Domain Set for Clinical Trials of Shoulder Disorders: A Report from the OMERACT 2016 Shoulder Core Outcome Set Special Interest Group.

    Science.gov (United States)

    Buchbinder, Rachelle; Page, Matthew J; Huang, Hsiaomin; Verhagen, Arianne P; Beaton, Dorcas; Kopkow, Christian; Lenza, Mario; Jain, Nitin B; Richards, Bethan; Richards, Pamela; Voshaar, Marieke; van der Windt, Danielle; Gagnier, Joel J

    2017-12-01

    The Outcome Measures in Rheumatology (OMERACT) Shoulder Core Outcome Set Special Interest Group (SIG) was established to develop a core outcome set (COS) for clinical trials of shoulder disorders. In preparation for OMERACT 2016, we systematically examined all outcome domains and measurement instruments reported in 409 randomized trials of interventions for shoulder disorders published between 1954 and 2015. Informed by these data, we conducted an international Delphi consensus study including shoulder trial experts, clinicians, and patients to identify key domains that should be included in a shoulder disorder COS. Findings were discussed at a stakeholder premeeting of OMERACT. At OMERACT 2016, we sought consensus on a preliminary core domain set and input into next steps. There were 13 and 15 participants at the premeeting and the OMERACT 2016 SIG meeting, respectively (9 attended both meetings). Consensus was reached on a preliminary core domain set consisting of an inner core of 4 domains: pain, physical function/activity, global perceived effect, and adverse events including death. A middle core consisted of 3 domains: emotional well-being, sleep, and participation (recreation and work). An outer core of research required to inform the final COS was also formulated. Our next steps are to (1) analyze whether participation (recreation and work) should be in the inner core, (2) conduct a third Delphi round to finalize definitions and wording of domains and reach final endorsement for the domains, and (3) determine which instruments fulfill the OMERACT criteria for measuring each domain.

  12. An intervention program for ADHD in patients with substance use disorders: preliminary results of a field trial

    NARCIS (Netherlands)

    Goossensen, M. Anne; van de Glind, Geurt; Carpentier, Pieter-Jan; Wijsen, Riek M. A.; van Duin, Daniëlle; Kooij, J. J. Sandra

    2006-01-01

    The comorbidity of attention deficit hyperactivity disorder (ADHD) is frequently not well recognized in substance abuse treatment institutions in The Netherlands. As a consequence, patients with substance use disorder (SUD) and ADHD often receive suboptimal treatment. To prevent every treatment

  13. Attentional Performance in Children and Adolescents with Tic Disorder and Co-Occurring Attention-Deficit/hyperactivity Disorder: New Insights from a 2 x 2 Factorial Design Study

    Science.gov (United States)

    Greimel, Ellen; Wanderer, Sina; Rothenberger, Aribert; Herpertz-Dahlmann, Beate; Konrad, Kerstin; Roessner, Veit

    2011-01-01

    The aim of the present study was to investigate the effect of both tic disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) on attentional functions. N = 96 children and adolescents participated in the study, including n = 21 subjects with TD, n = 23 subjects with ADHD, n = 25 subjects with TD+ADHD, and n = 27 controls. Attentional…

  14. Cortical Inhibition in Attention Deficit Hyperactivity Disorder: New Insights from the Electroencephalographic Response to Transcranial Magnetic Stimulation

    Science.gov (United States)

    Bruckmann, Sarah; Hauk, Daniela; Roessner, Veit; Resch, Franz; Freitag, Christine M.; Kammer, Thomas; Ziemann, Ulf; Rothenberger, Aribert; Weisbrod, Matthias; Bender, Stephan

    2012-01-01

    Attention deficit hyperactivity disorder is one of the most frequent neuropsychiatric disorders in childhood. Transcranial magnetic stimulation studies based on muscle responses (motor-evoked potentials) suggested that reduced motor inhibition contributes to hyperactivity, a core symptom of the disease. Here we employed the N100 component of the…

  15. Onset, Timing, and Exposure Therapy of Stress Disorders: Mechanistic Insight from a Mathematical Model of Oscillating Neuroendocrine Dynamics (Open Access)

    Science.gov (United States)

    2016-03-25

    where PTSD patients are subjected to stres- sors in a controlled and safe manner, using for example, computer-simulated “ virtual reality exposure...1994;134(3):1528–36. 48. Averill P, Beck J. Posttraumatic stress disorder in older adults: a conceptual review. J Anxiety Disord. 2000;14(2):133–56

  16. The relationship between clinical characteristics, metacognitive appraisals, and cognitive insight in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Ekinci, Okan; Ekinci, Asli

    2016-11-01

    Cognitive insight, a recently developed insight measure, refers to metacognitive processes of the re-evaluation and correction of distorted beliefs and misinterpretations. However, to the best of the authors' knowledge, no study has specifically examined cognitive insight, demographics, psychopathological variables, and distorted beliefs in OCD. The aim of this research was to examine links between cognitive insight and demographics, clinical factors, and distorted beliefs among patients with OCD. Eighty-four consecutive outpatients with a diagnosis of OCD underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Cognitive Insight Scale (BCIS), Thought-Action Fusion Scale (TAFS), White Bear Thought Suppression Inventory, Metacognition Questioniarre-30 (MCQ-30), and a sociodemographic questionnaire. In addition, 82 control subjects matched for age, education, and gender were tested. BCIS-self-certainty scores were all substantially higher in subjects with remitted and unremitted OCD than in healthy comparison subjects, while BCIS-composite scores were significantly lower in both patient groups than controls. Obsession and compulsion severity had significant effects on BCIS scores. In addition, it was found that the specific symptoms were linked to self-certainty scores. Self-reflectiveness and composite scores had positive correlations with the sub-scale scores of the MCQ-30, while the TAF-morality score was positively correlated with self-certainty scores. The results demonstrated poor cognitive insight among remitted and unremitted OCD patients. In addition, the present study suggested significant associations between sociodemographic and clinical features and dysfunctional appraisals. Cognitive-behavioural techniques aimed at enhancing cognitive insight may be beneficial for patients with OCD, particularly patients who have prominent dysfunctional beliefs.

  17. Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants

    Science.gov (United States)

    Zwaigenbaum, Lonnie; Bryson, Susan; Lord, Catherine; Rogers, Sally; Carter, Alice; Carver, Leslie; Chawarska, Kasia; Constantino, John; Dawson, Geraldine; Dobkins, Karen; Fein, Deborah; Iverson, Jana; Klin, Ami; Landa, Rebecca; Messinger, Daniel; Ozonoff, Sally; Sigman, Marian; Stone, Wendy; Tager-Flusberg, Helen; Yirmiya, Nurit

    2010-01-01

    With increased public awareness of the early signs and recent American Academy of Pediatrics recommendations that all 18- and 24-month-olds be screened for autism spectrum disorders, there is an increasing need for diagnostic assessment of very young children. However, unique challenges exist in applying current diagnostic guidelines for autism spectrum disorders to children under the age of 2 years. In this article, we address challenges related to early detection, diagnosis, and treatment of autism spectrum disorders in this age group. We provide a comprehensive review of findings from recent studies on the early development of children with autism spectrum disorders, summarizing current knowledge on early signs of autism spectrum disorders, the screening properties of early detection tools, and current best practice for diagnostic assessment of autism spectrum disorders before 2 years of age. We also outline principles of effective intervention for children under the age of 2 with suspected/confirmed autism spectrum disorders. It is hoped that ongoing studies will provide an even stronger foundation for evidence-based diagnostic and intervention approaches for this critically important age group. PMID:19403506

  18. Stronger default mode network connectivity is associated with poorer clinical insight in youth at ultra high-risk for psychotic disorders.

    Science.gov (United States)

    Clark, Sarah V; Mittal, Vijay A; Bernard, Jessica A; Ahmadi, Aral; King, Tricia Z; Turner, Jessica A

    2018-03-01

    Impaired clinical insight (CI) is a common symptom of psychotic disorders and a promising treatment target. However, to date, our understanding of how variability in CI is tied to underlying brain dysfunction in the clinical high-risk period is limited. Developing a stronger conception of this link will be a vital first step for efforts to determine if CI can serve as a useful prognostic indicator. The current study investigated whether variability in CI is related to major brain networks in adolescents and young adults at ultra high-risk (UHR) of developing psychosis. Thirty-five UHR youth were administered structured clinical interviews as well as an assessment for CI and underwent resting-state magnetic resonance imaging scans. Functional connectivity was calculated in the default mode network (DMN) and fronto-parietal network (FPN), two major networks that are dysfunctional in psychosis and are hypothesized to affect insight. Greater DMN connectivity between the posterior cingulate/precuneus and ventromedial prefrontal cortex (DMN) was related to poorer CI (R 2 =0.399). There were no significant relationships between insight and the FPN. This is the first study to relate a major brain network to clinical insight before the onset of psychosis. Findings are consistent with evidence if a hyperconnected DMN in schizophrenia and UHR, and similar to a previous study of insight and connectivity in schizophrenia. Results suggest that a strongly connected DMN may be related to poor self-awareness of subthreshold psychotic symptoms in UHR adolescents and young adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. From mental-physical comorbidity to somatic symptoms - insights gained from research on symptoms of mental disorders

    OpenAIRE

    Rodic, Donja

    2015-01-01

    Abstract in English Background: Mental health and physical health are substantially associated with each other. The early recognition of co-occurring mental-physical conditions, as well as the early recognition of pathophysiological mechanisms underlying somatic symptoms, might be of special relevance for a better understanding of early phases of disorder development and hence prevention. Aim: To examine associations between symptoms of mental disorders (depressive symptoms and gambli...

  20. New insights into the endophenotypic status of cognition in bipolar disorder: genetic modelling study of twins and siblings.

    Science.gov (United States)

    Georgiades, Anna; Rijsdijk, Fruhling; Kane, Fergus; Rebollo-Mesa, Irene; Kalidindi, Sridevi; Schulze, Katja K; Stahl, Daniel; Walshe, Muriel; Sahakian, Barbara J; McDonald, Colm; Hall, Mei-Hua; Murray, Robin M; Kravariti, Eugenia

    2016-06-01

    Twin studies have lacked statistical power to apply advanced genetic modelling techniques to the search for cognitive endophenotypes for bipolar disorder. To quantify the shared genetic variability between bipolar disorder and cognitive measures. Structural equation modelling was performed on cognitive data collected from 331 twins/siblings of varying genetic relatedness, disease status and concordance for bipolar disorder. Using a parsimonious AE model, verbal episodic and spatial working memory showed statistically significant genetic correlations with bipolar disorder (rg = |0.23|-|0.27|), which lost statistical significance after covarying for affective symptoms. Using an ACE model, IQ and visual-spatial learning showed statistically significant genetic correlations with bipolar disorder (rg = |0.51|-|1.00|), which remained significant after covarying for affective symptoms. Verbal episodic and spatial working memory capture a modest fraction of the bipolar diathesis. IQ and visual-spatial learning may tap into genetic substrates of non-affective symptomatology in bipolar disorder. © The Royal College of Psychiatrists 2016.

  1. Newer insights into the role of miRNA a tiny genetic tool in psychiatric disorders: focus on post-traumatic stress disorder

    Science.gov (United States)

    Giridharan, V V; Thandavarayan, R A; Fries, G R; Walss-Bass, C; Barichello, T; Justice, N J; Reddy, M K; Quevedo, J

    2016-01-01

    Post-traumatic stress disorder (PTSD) is a mental disorder occurring in about 2–9% of individuals after their exposure to life-threatening events, such as severe accidents, sexual abuse, combat or a natural catastrophe. Because PTSD patients are exposed to trauma, it is likely that epigenetic modifications have an important role in disease development and prognosis. For the past two decades, abnormal expression of the epigenetic regulators microRNAs (miRs) and miR-mediated gene regulation have been given importance in a variety of human diseases, such as cancer, heart disease and viral infection. Emerging evidence supports a role for miR dysregulation in psychiatric and neurological disorders, including schizophrenia, bipolar disorder, anxiety, major depressive disorder, autism spectrum disorder and Tourette's syndrome. Recently mounting of evidence supports the role of miR both in preclinical and clinical settings of psychiatric disorders. Abnormalities in miR expression can fine-tune the expression of multiple genes within a biological network, suggesting that miR dysregulation may underlie many of the molecular changes observed in PTSD pathogenesis. This provides strong evidence that miR not only has a critical role in PTSD pathogenesis, but can also open up new avenues for the development of diagnostic tools and therapeutic targets for the PTSD phenotype. In this review, we revisit some of the recent evidence associated with miR and PTSD in preclinical and clinical settings. We also discuss the possible clinical applications and future use of miRs in PTSD therapy. PMID:27845777

  2. Newer insights into the role of miRNA a tiny genetic tool in psychiatric disorders: focus on post-traumatic stress disorder.

    Science.gov (United States)

    Giridharan, V V; Thandavarayan, R A; Fries, G R; Walss-Bass, C; Barichello, T; Justice, N J; Reddy, M K; Quevedo, J

    2016-11-15

    Post-traumatic stress disorder (PTSD) is a mental disorder occurring in about 2-9% of individuals after their exposure to life-threatening events, such as severe accidents, sexual abuse, combat or a natural catastrophe. Because PTSD patients are exposed to trauma, it is likely that epigenetic modifications have an important role in disease development and prognosis. For the past two decades, abnormal expression of the epigenetic regulators microRNAs (miRs) and miR-mediated gene regulation have been given importance in a variety of human diseases, such as cancer, heart disease and viral infection. Emerging evidence supports a role for miR dysregulation in psychiatric and neurological disorders, including schizophrenia, bipolar disorder, anxiety, major depressive disorder, autism spectrum disorder and Tourette's syndrome. Recently mounting of evidence supports the role of miR both in preclinical and clinical settings of psychiatric disorders. Abnormalities in miR expression can fine-tune the expression of multiple genes within a biological network, suggesting that miR dysregulation may underlie many of the molecular changes observed in PTSD pathogenesis. This provides strong evidence that miR not only has a critical role in PTSD pathogenesis, but can also open up new avenues for the development of diagnostic tools and therapeutic targets for the PTSD phenotype. In this review, we revisit some of the recent evidence associated with miR and PTSD in preclinical and clinical settings. We also discuss the possible clinical applications and future use of miRs in PTSD therapy.

  3. A Preliminary Investigation of Associations between Disorders of Behavior and Language in Children with Chronic Otitis Media.

    Science.gov (United States)

    Funk, Jeanne B.; Ruppert, Elizabeth S.

    1986-01-01

    The relationship between language and behavior disorders was investigated. The teacher and parents of 12 children in a special public preschool for children with documented chronic otitis media and language disorders completed the Louisville Behavior Checklist. Most deviant behavior was reported on scales measuring cognitive and social-interactive…

  4. A Preliminary Transcranial Magnetic Stimulation Study of Cortical Inhibition and Excitability in High-Functioning Autism and Asperger Disorder

    Science.gov (United States)

    Enticott, Peter G.; Rinehart, Nicole J.; Tonge, Bruce J.; Bradshaw, John L.; Fitzgerald, Paul B.

    2010-01-01

    Aim: Controversy surrounds the distinction between high-functioning autism (HFA) and Asperger disorder, but motor abnormalities are associated features of both conditions. This study examined motor cortical inhibition and excitability in HFA and Asperger disorder using transcranial magnetic stimulation (TMS). Method: Participants were diagnosed by…

  5. The Interaction of Motivation and Therapist Adherence Predicts Outcome in Cognitive Behavioral Therapy for Panic Disorder: Preliminary Findings

    Science.gov (United States)

    Huppert, Jonathan D.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2006-01-01

    This report is a post-hoc, exploratory examination of the relationships among patient motivation, therapist protocol adherence, and panic disorder outcome in patients treated with cognitive behavioral therapy within the context of a randomized clinical trial for the treatment of panic disorder (Barlow, Gorman, Shear, & Woods, 2000). Results…

  6. Effects of distractors on upright balance performance in school-aged children with attention deficit hyperactivity disorder, preliminary study.

    Science.gov (United States)

    Aydinli, Fatma Esen; Çak, Tuna; Kirazli, Meltem Çiğdem; Çinar, Betül Çiçek; Pektaş, Alev; Çengel, Ebru Kültür; Aksoy, Songül

    2016-11-17

    Attention deficit hyperactivity disorder is a common impairing neuropsychiatric disorder with onset in early childhood. Almost half of the children with attention deficit hyperactivity disorder also experience a variety of motor-related dysfunctions ranging from fine/gross motor control problems to difficulties in maintaining balance. The main purpose of this study was to investigate the effects of distractors two different auditory distractors namely, relaxing music and white noise on upright balance performance in children with attention deficit hyperactivity disorder. We compared upright balance performance and the involvement of different sensory systems in the presence of auditory distractors between school-aged children with attention deficit hyperactivity disorder (n=26) and typically developing controls (n=20). Neurocom SMART Balance Master Dynamic Posturography device was used for the sensory organization test. Sensory organization test was repeated three times for each participant in three different test environments. The balance scores in the silence environment were lower in the attention deficit hyperactivity disorder group but the differences were not statistically significant. In addition to lower balance scores the visual and vestibular ratios were also lower. Auditory distractors affected the general balance performance positively for both groups. More challenging conditions, using an unstable platform with distorted somatosensory signals were more affected. Relaxing music was more effective in the control group, and white noise was more effective in the attention deficit hyperactivity disorder group and the positive effects of white noise became more apparent in challenging conditions. To the best of our knowledge, this is the first study evaluating balance performance in children with attention deficit hyperactivity disorder under the effects of auditory distractors. Although more studies are needed, our results indicate that auditory distractors

  7. Targeting premeal anxiety in eating disordered clients and normal controls: a preliminary investigation into the use of mindful eating vs. distraction during food exposure.

    Science.gov (United States)

    Marek, Ryan J; Ben-Porath, Denise D; Federici, Anita; Wisniewski, Lucene; Warren, Mark

    2013-09-01

    Studies have demonstrated that negative affect increases prior to food intake in individuals diagnosed with an eating disorder. Mindfulness has been supported empirically to treat experiential avoidance stemming from anxiety. Thus, the current objective in this study is to empirically compare mindfulness vs. thought suppression invention during a food exposure in both clinical and nonclinical samples. In a 2 (Group: clinical vs. nonclinical) × 2 (INTERVENTION: mindfulness vs. distraction) counterbalanced within treatment design, the current investigation sought to determine the differential effectiveness of a brief mindfulness intervention vs. a brief distraction intervention in women diagnosed with AN and BN in a clinical and nonclinical sample during a food exposure. Results indicated that the eating disorder group reported a significant increase in negative affect after the mindfulness intervention as compared to the distraction intervention, whereas the nonclinical group reported a significant decrease in negative affect after the mindfulness intervention as compared to the distraction intervention. Preliminary findings suggest that clinicians may want to proceed cautiously when using mindful eating in those with severe eating disorders during the early stages of food exposure. Limitations and future directions are discussed. Copyright © 2013 Wiley Periodicals, Inc.

  8. Aripiprazole plus topiramate in opioid-dependent patients with schizoaffective disorder: an 8-week, open-label, uncontrolled, preliminary study.

    Science.gov (United States)

    Bruno, Antonio; Romeo, Vincenzo M; Pandolfo, Gianluca; Scimeca, Giuseppe; Zoccali, Rocco A; Muscatello, Maria Rosaria A

    2014-01-01

    The aims of this study were to evaluate a combination of aripiprazole and topiramate in the treatment of opioid-dependent patients with schizoaffective disorder undergoing methadone maintenance therapy (MMT) and, further, to taper off patients from methadone treatment. Twenty patients who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for opioid dependence and schizoaffective disorder receiving MMT (80 mg/day) were given aripiprazole (10 mg/day) plus topiramate (up to 200 mg/day) for 8 weeks. A methadone dose reduction of 3 mg/day until suspension at week 4 was established. Aripiprazole plus topiramate was effective in reducing clinical symptoms, and a rapid tapering off of MMT was achieved. Combining aripiprazole and topiramate may be effective in patients with a dual diagnosis of opioid dependency and schizoaffective disorder.

  9. Violations of Personal Space in Young People with Autism Spectrum Disorders and Williams Syndrome: Insights from the Social Responsiveness Scale

    Science.gov (United States)

    Lough, Emma; Hanley, Mary; Rodgers, Jacqui; South, Mikle; Kirk, Hannah; Kennedy, Daniel P.; Riby, Deborah M.

    2015-01-01

    Interpersonal distance regulation is crucial for successful social interactions. We investigated personal space awareness in Williams syndrome (WS) and autism spectrum disorder (ASD) compared to typical development. Parents reported that individuals with WS and ASD were significantly more likely than those developing typically to invade the…

  10. Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Chronis-Tuscano, Andrea; Clarke, Tana L; O'Brien, Kelly A; Raggi, Veronica L; Diaz, Yamalis; Mintz, Abigail D; Rooney, Mary E; Knight, Laura A; Seymour, Karen E; Thomas, Sharon R; Seeley, John; Kosty, Derek; Lewinsohn, Peter

    2013-10-01

    More than 50% of mothers of children with attention-deficit/hyperactivity disorder (ADHD) have a lifetime history of major depressive disorder (MDD). Maternal depressive symptoms are associated with impaired parenting and predict adverse developmental and treatment outcomes for children with ADHD. For these reasons, we developed and examined the preliminary efficacy of an integrated treatment targeting parenting and depressive symptoms for mothers of children with ADHD. This integrated intervention incorporated elements of 2 evidence-based treatments: behavioral parent training (BPT) and cognitive behavioral depression treatment. Ninety-eight mothers with at least mild depressive symptoms were randomized to receive either standard BPT (n = 51) or the integrated parenting intervention for ADHD (IPI-A; n = 47). Participants were assessed at baseline, posttreatment, and 3- to 6-month follow-up on measures of (a) self-reported maternal depressive symptoms, (b) observed positive and negative parenting, and (c) observed and mother-reported child disruptive behavior and mother-reported child and family impairment. The IPI-A produced effects of small to moderate magnitude relative to BPT on maternal depressive symptoms, observed negative parenting, observed child deviance, and child impairment at posttreatment and on maternal depressive symptoms, child disruptive behavior, child impairment and family functioning at follow-up. Contrary to expectations, the BPT group demonstrated moderate to large effects relative to IPI-A on observed positive parenting at follow-up. This treatment development study provides encouraging preliminary support for the integrated intervention targeting parenting and depressive symptoms in mothers of children with ADHD. Future studies should examine whether this integrated intervention improves long-term developmental outcomes for children with ADHD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  11. The successful pharmacological treatment of adolescents and young adults with borderline personality disorder: a preliminary open trial of flupenthixol.

    Science.gov (United States)

    Kutcher, S; Papatheodorou, G; Reiter, S; Gardner, D

    1995-01-01

    Borderline personality disorder is a significantly disabling disturbance often arising in adolescents or young adults. In the absence of demonstrated effective treatments in this population, this open prospective study evaluated the effect of low dose (3 mg per day) flupenthixol in 13 rigorously diagnosed adolescents with borderline personality disorder. Therapeutic outcome over eight weeks of treatment assessed across measures of impulsivity, depression/dysphoria, general psychopathology and global functioning showed significant improvement in all spheres. These findings suggest that low dose flupenthixol may have a role to play in the short-term treatment of this population. PMID:7703220

  12. Cognitive-behavioural group therapy versus guided self-help for compulsive buying disorder: a preliminary study.

    Science.gov (United States)

    Müller, A; Arikian, A; de Zwaan, M; Mitchell, J E

    2013-01-01

    Compulsive buying (CB) is defined as extreme preoccupation with buying/shopping and frequent buying that causes substantial negative psychological, social, occupational and financial consequences. There exists preliminary evidence that group cognitive-behavioural therapy (CBT) is effective in the treatment of CB. The present pilot study made a first attempt to compare group CBT for CB with telephone-guided self-help (GSH). Fifty-six patients were allocated randomly to one of the three conditions: (1) group CBT (n = 22); (2) GSH (n = 20); and (3) a waiting list condition (n = 14). The results indicate that face-to-face group CBT is superior not only to the waiting list condition but also to GSH. Patients who received GSH tended to have more success in overcoming CB compared with the waiting list controls. Given the sample size, the results must be considered as preliminary and further research is needed to address the topic whether GSH also could be a helpful intervention in reducing CB. Copyright © 2011 John Wiley & Sons, Ltd.

  13. Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

    Directory of Open Access Journals (Sweden)

    Katya Rubinstein

    2014-03-01

    Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

  14. Child- And Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: Development and Preliminary Results.

    Science.gov (United States)

    Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.

    2004-01-01

    Objective: To describe child- and family-focused cognitive-behavioral therapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1)…

  15. Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response.

    Science.gov (United States)

    Storch, Eric A; Zavrou, Sophia; Collier, Amanda B; Ung, Danielle; Arnold, Elysse B; Mutch, P Jane; Lewin, Adam B; Murphy, Tanya K

    2015-08-01

    Anxiety symptoms are common in youth with autism spectrum disorders (ASD) and directly associated with symptom severity and functional impairment. Family accommodation occurs frequently among individuals with obsessive-compulsive and anxiety disorders; to date, no data exist on the nature and correlates of family accommodation in youth with ASD and anxiety, as well as its relationship to cognitive-behavioral therapy outcome. Forty children with ASD and a comorbid anxiety disorder participated. Clinicians administered measures of ASD and anxiety disorder caseness, anxiety symptom severity, and family accommodation; parents completed questionnaires assessing social responsiveness, internalizing and externalizing behaviors, and functional impairment. A subsample of youth (n = 24) completed a course of cognitive-behavioral therapy. Family accommodation was common and positively correlated with anxiety symptom severity, but not functional impairment, general internalizing symptoms, externalizing behavior, or social responsiveness. Family accommodation decreased following cognitive-behavioral therapy with decreases in family accommodation being associated with decreases in anxiety levels. Treatment responders reported lower family accommodation frequency and lower parent impact relative to non-responders. Clinical implications of this study in assessing and psychotherapeutically treating youth with ASD and comorbid anxiety are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Psychosocial and Computer-Assisted Intervention for College Students with Autism Spectrum Disorder: Preliminary Support for Feasibility

    Science.gov (United States)

    White, Susan W.; Richey, John A.; Gracanin, Denis; Coffman, Marika; Elias, Rebecca; LaConte, Stephen; Ollendick, Thomas H.

    2016-01-01

    The number of young adults with Autism Spectrum Disorders (ASD) enrolled in higher education institutions has steadily increased over the last decade. Despite this, there has been little research on how to most effectively support this growing population. The current study presents data from a pilot trial of two novel intervention programs…

  17. Mindfulness moderates the relationship between aggression and Antisocial Personality Disorder traits : Preliminary investigation with an offender sample

    NARCIS (Netherlands)

    Velotti, P.; Garofalo, C.; D’Aguanno, M.; Petrocchi, C.; Popolo, R.; Salvatore, G.; Dimaggio, G.

    2016-01-01

    Introduction Poor mentalizing has been described as a characteristic of Antisocial Personality Disorder (ASPD), along with the well-established role of aggressiveness. In the current study, we tested this hypothesis focusing on a specific aspect of mentalization (i.e., mindfulness). Method We

  18. Heart Rate Profiles of Children with and without Autism Spectrum Disorder in Response to Physical Play: A Preliminary Investigation

    Science.gov (United States)

    Breslin, Casey M.; Rudisill, Mary E.; Wadsworth, Danielle W.

    2015-01-01

    In this study, the heart rate response of children with and without autism spectrum disorder (ASD) exposed to outdoor free play sessions during preschool was examined. Participants (n = 7; four children with ASD and three children who show typical development) wore Actiheart heart rate monitors during 6 school days. Using a single-subject design,…

  19. Attentional performance in children and adolescents with tic disorder and co-occurring attention-deficit/hyperactivity disorder: new insights from a 2 × 2 factorial design study.

    Science.gov (United States)

    Greimel, Ellen; Wanderer, Sina; Rothenberger, Aribert; Herpertz-Dahlmann, Beate; Konrad, Kerstin; Roessner, Veit

    2011-08-01

    The aim of the present study was to investigate the effect of both tic disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) on attentional functions. N=96 children and adolescents participated in the study, including n=21 subjects with TD, n=23 subjects with ADHD, n=25 subjects with TD+ADHD, and n=27 controls. Attentional performance was tested based on four computerized attention tasks (sustained attention, divided attention, go/nogo and set shifting). The effect of TD as well as ADHD on attentional performance was tested using a 2 × 2 factorial approach. A diagnosis of TD had no negative impact on attentional functions but was associated with improved performance in the set shifting task. By contrast, regardless of a diagnosis of TD, subjects with ADHD were found to perform worse in the sustained attention, divided attention and go/nogo task. No interaction effect between the factors TD and ADHD was revealed for any of the attention measures. Our results add to findings from other areas of research, showing that in subjects with TD and ADHD, ADHD psychopathology is often the main source of impairment, whereas a diagnosis of TD has little or no impact on neuropsychological performance in most cases and even seems to be associated with adaptive mechanisms.

  20. The characteristics of women who use hypnotherapy for intrapartum pain management: Preliminary insights from a nationally-representative sample of Australian women.

    Science.gov (United States)

    Steel, A; Frawley, J; Sibbritt, D; Broom, A; Adams, J

    2016-04-01

    This manuscript presents a preliminary examination of the characteristics of women who choose intrapartum hypnosis for pain management. Cross-sectional analysis of 2445 women (31-36 years) from a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH), employing Fisher exact tests. Australia. Use of intrapartum hypnosis, or hypnobirthing, for pain management during labour and birth. Women using hypnobirthing were more likely to have consulted with an acupuncturist or naturopath, or attended yoga/meditation classes during pregnancy (phypnotherapy for intrapartum pain management less commonly identified as feeling safer knowing that an obstetrician is providing their care (phypnotherapy for intrapartum pain management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2013-11-01

    Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  2. A Prospective Birth Cohort Study on Maternal Cholesterol Levels and Offspring Attention Deficit Hyperactivity Disorder: New Insight on Sex Differences.

    Science.gov (United States)

    Ji, Yuelong; Riley, Anne W; Lee, Li-Ching; Volk, Heather; Hong, Xiumei; Wang, Guoying; Angomas, Rayris; Stivers, Tom; Wahl, Anastacia; Ji, Hongkai; Bartell, Tami R; Burd, Irina; Paige, David; Fallin, Margaret D; Zuckerman, Barry; Wang, Xiaobin

    2017-12-23

    Growing evidence suggests that maternal cholesterol levels are important in the offspring's brain growth and development. Previous studies on cholesterols and brain functions were mostly in adults. We sought to examine the prospective association between maternal cholesterol levels and the risk of attention deficit hyperactivity disorder (ADHD) in the offspring. We analyzed data from the Boston Birth Cohort, enrolled at birth and followed from birth up to age 15 years. The final analyses included 1479 mother-infant pairs: 303 children with ADHD, and 1176 neurotypical children without clinician-diagnosed neurodevelopmental disorders. The median age of the first diagnosis of ADHD was seven years. The multiple logistic regression results showed that a low maternal high-density lipoprotein level (≤60 mg/dL) was associated with an increased risk of ADHD, compared to a higher maternal high-density lipoprotein level, after adjusting for pertinent covariables. A "J" shaped relationship was observed between triglycerides and ADHD risk. The associations with ADHD for maternal high-density lipoprotein and triglycerides were more pronounced among boys. The findings based on this predominantly urban low-income minority birth cohort raise a new mechanistic perspective for understanding the origins of ADHD and the gender differences and future targets in the prevention of ADHD.

  3. The Body Dysmorphic Disorder Symptom Scale: Development and preliminary validation of a self-report scale of symptom specific dysfunction.

    Science.gov (United States)

    Wilhelm, Sabine; Greenberg, Jennifer L; Rosenfield, Elizabeth; Kasarskis, Irina; Blashill, Aaron J

    2016-06-01

    The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a new self-report measure used to examine the severity of a wide variety of symptoms associated with body dysmorphic disorder (BDD). The BDD-SS was designed to differentiate, for each group of symptoms, the number of symptoms endorsed and their severity. This report evaluates and compares the psychometric characteristics of the BDD-SS in relation to other measures of BDD, body image, and depression in 99 adult participants diagnosed with BDD. Total scores of the BDD-SS showed good reliability and convergent validity and moderate discriminant validity. Analyses of the individual BDD-SS symptom groups confirmed the reliability of the checking, grooming, weight/shape, and cognition groups. The current findings indicate that the BDD-SS can be quickly administered and used to examine the severity of heterogeneous BDD symptoms for research and clinical purposes. Copyright © 2016. Published by Elsevier Ltd.

  4. Technical clearance for mental disorders among the servers in the city hall of Manaus: a preliminary analysis

    Directory of Open Access Journals (Sweden)

    Vívian Silva Lima Marangoni

    2017-01-01

    Full Text Available This study aimed to investigate the occurrence of work absenteeism due to mental disorders among the servers of the Prefeitura Municipal de Manaus - PMM, registered by the Junta Médica do Município, in the period January to December 2011. It was found, after the documentary analysis, data of extreme significance that converge with numerous studies which indicate the nature of work as a risk factor for mental illness. It is through them that mental disorders has been a major cause of absence from work activities, especially among the servers in the area of health and education, representing 10% of total permits issued in 2011. These findings may support future studies that focus on health promotion and quality of life of these professionals, thus becoming a major challenge for policy makers

  5. Searching the Internet for psychiatric disorders among Arab and Jewish Israelis: insights from a comprehensive infodemiological survey

    Directory of Open Access Journals (Sweden)

    Mohammad Adawi

    2018-03-01

    Full Text Available Israel represents a complex and pluralistic society comprising two major ethno-national groups, Israeli Jews and Israeli Arabs, which differ in terms of religious and cultural values as well as social constructs. According to the so-called “diversification hypothesis”, within the framework of e-health and in the era of new information and communication technologies, seeking online health information could be a channel to increase health literacy, especially among disadvantaged groups. However, little is known concerning digital seeking behavior and, in particular, digital mental health literacy. This study was conducted in order to fill in this gap. Concerning raw figures, unadjusted for confounding variables (time, population size, Internet penetration index, disease rate, “depression” searched in Hebrew was characterized by 1.5 times higher search volumes, slightly declining throughout time, whereas relative search volumes (RSVs related to “depression” searched in Arabic tended to increase over the years. Similar patterns could be detected for “phobia” (in Hebrew 1.4-fold higher than in Arabic and for “anxiety” (with the searches performed in Hebrew 2.3 times higher than in Arabic. “Suicide” in Hebrew was searched 2.0-fold more than in Arabic (interestingly for both languages search volumes exhibited seasonal cyclic patterns. Eating disorders were searched more in Hebrew: 8.0-times more for “bulimia”, whilst “anorexia” was searched in Hebrew only. When adjusting for confounding variables, association between digital seeking behavior and ethnicity remained statistically significant (p-value < 0.0001 for all psychiatric disorders considered in the current investigation, except for “bulimia” (p = 0.989. More in details, Israeli Arabs searched for mental health disorders less than Jews, apart from “depression”. Arab and Jewish Israelis, besides differing in terms of language, religion, social and cultural

  6. A preliminary evaluation of the validity of binge-eating disorder defining features in a community-based sample.

    Science.gov (United States)

    Klein, Kelly M; Forney, K Jean; Keel, Pamela K

    2016-05-01

    Little empirical attention has been paid to the DSM-5 definition of binge-eating disorder (BED), particularly to the associated features of binge episodes. The present study sought to determine how the associated features and undue influence of weight/shape on self-evaluation contribute to evidence of a clinically significant eating disorder. Secondary analyses were conducted on data (N = 80; 76.3% women, 76.3% Caucasian, ages 18-43) collected through an epidemiological study of eating patterns. Descriptive statistics were used to report the sample prevalence of the features, independently and in combination. Correlations and alpha reliability were employed to examine relationships among associated features, distress regarding bingeing, and clinical diagnosis. Regression models and receiver-operating characteristic (ROC) curves were used to determine the utility of the features for explaining variance in distress. Internal consistency reliability for indicators was low, and several features demonstrated low or nonsignificant associations with distress and diagnosis. Feeling disgusted/depressed/guilty was the only unique predictor of distress (p = 0.001). For the ROC curves, three features was the best threshold for predicting distress. Results support the need to refine the features to ensure better detection of clinically significant eating pathology for research inclusion and treatment of the illness. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:524-528). © 2015 Wiley Periodicals, Inc.

  7. Association between stress-related sleep reactivity and cognitive processes in insomnia disorder and insomnia subgroups: preliminary results.

    Science.gov (United States)

    Palagini, Laura; Faraguna, Ugo; Mauri, Mauro; Gronchi, Alessia; Morin, Charles M; Riemann, Dieter

    2016-03-01

    Stress-related sleep reactivity, sleep-related cognitions, and psychological factors play an important role in insomnia. The aim was to investigate their possible association in Insomnia Disorder, insomnia subgroups, and healthy subjects. The cross-sectional study consisted of 93 subjects who met diagnostic criteria for Insomnia Disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and of 30 healthy subjects. Survey instruments included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Ford Insomnia Response to Stress Test (FIRST), Dysfunctional Beliefs about Sleep scale (DBAS), Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS). Descriptive statistics, Pearson correlations, χ(2)-test, and multiple linear regression were performed. FIRST and SAS best determined the insomnia subjects vs good sleepers (FIRST χ(2) = 109.6, p insomnia, stress-related sleep reactivity, and psychological factors, such as anxiety symptoms, may distinguish insomnia subjects from good sleepers; (2) sleep reactivity and sleep-related cognitions seem interrelated, unhelpful beliefs may affect the stress reactivity; (3) psychological factors may influence sleep quality and the severity of insomnia; (4) these important sleep-related variables may have similar associations in insomnia subgroups; they may constitute the core factors for insomnia development and maintenance. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Neurobehavioural assessment and diagnosis in disorders of consciousness: a preliminary study of the Sensory Tool to Assess Responsiveness (STAR).

    Science.gov (United States)

    Stokes, Verity; Gunn, Sarah; Schouwenaars, Katie; Badwan, Derar

    2018-09-01

    The Sensory Tool to Assess Responsiveness (STAR) is an interdisciplinary neurobehavioural diagnostic tool for individuals with prolonged disorders of consciousness. It utilises current diagnostic criteria and is intended to improve upon the high misdiagnosis rate in this population. This study assesses the inter-rater reliability of the STAR and its diagnostic validity in comparison with the Coma Recovery Scale-Revised (CRS-R) and the Wessex Head Injury Matrix (WHIM). Participants were patients with severe acquired brain injury resulting in a disorder of consciousness, who were admitted to the Royal Leamington Spa Rehabilitation Hospital between 1999 and 2009. Patients underwent sensory stimulation sessions during their period of admission, which were recorded on video. Using this footage, patients were re-assessed for this study using the STAR, WHIM and CRS-R criteria. The STAR demonstrated "moderate" inter-rater reliability, "substantial" diagnostic agreement with the CRS-R, and "moderate" agreement with the WHIM. There were no significant differences between diagnoses assigned by the different assessments. The STAR demonstrated a good degree of inter-rater reliability in identification of diagnoses for patients with disorders of consciousness. The diagnostic outcomes of the STAR agreed at a good level with the CRS-R, moderately with the WHIM, and did not significantly differ from either. This demonstrates the reliability and validity of the STAR, showing its appropriateness for clinical use. Future longitudinal studies and research into the STAR's applicability in long-stay rehabilitation are indicated.

  9. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

    Science.gov (United States)

    Tak, Erwin C P M; van Hespen, Ariëtte T H; Verhaak, Peter F M; Eekhof, Just; Hopman-Rock, Marijke

    2016-07-01

    Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation. A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ-12)), depression (Geriatric Depression Scale 15-item version (GDS-15)), anxiety and suspicion (Symptom Checklist-90 (SCL-90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini-Mental State Examination (MMSE)). GPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ-12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre-set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas. The Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. Copyright © John Wliey & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Glia and immune cell signaling in bipolar disorder: insights from neuropharmacology and molecular imaging to clinical application.

    Science.gov (United States)

    Watkins, C C; Sawa, A; Pomper, M G

    2014-01-21

    Bipolar disorder (BD) is a debilitating mental illness characterized by severe fluctuations in mood, sleep, energy and executive functioning. Pharmacological studies of selective serotonin reuptake inhibitors and the monoamine system have helped us to clinically understand bipolar depression. Mood stabilizers such as lithium and valproic acid, the first-line treatments for bipolar mania and depression, inhibit glycogen synthase kinase-3 beta (GSK-3β) and regulate the Wnt pathway. Recent investigations suggest that microglia, the resident immune cells of the brain, provide a physiological link between the serotonin system and the GSK-3β/Wnt pathway through neuroinflammation. We review the pharmacological, translational and brain imaging studies that support a role for microglia in regulating neurotransmitter synthesis and immune cell activation. These investigations provide a model for microglia involvement in the pathophysiology and phenotype of BD that may translate into improved therapies.

  11. Mindfulness-based cognitive therapy for seasonal affective disorder : A pilot study

    NARCIS (Netherlands)

    Fleer, Joke; Schroevers, Maya; Panjer, Vera; Geerts, Erwin; Meesters, Ybe

    2014-01-01

    Background: The best available treatment for seasonal affective disorder (SAD) is light therapy. Yet, this treatment does not prevent recurrence of depression in subsequent seasons. The aim of the study is to gain preliminary insight in the efficacy of Mindfulness Based Cognitive Therapy (MBCT) in

  12. Preliminary Insight into Winter Native Fish Assemblages in Guadiana Estuary Salt Marshes Coping with Environmental Variability and Non-Indigenous Fish Introduction

    Directory of Open Access Journals (Sweden)

    Renata Gonçalves

    2017-10-01

    Full Text Available This work aims to undertake a preliminary characterization of winter fish assemblages in the salt marsh areas of Guadiana lower estuary (South-East Portugal and discusses the potential risks of habitat dominance by a non-indigenous species (NIS. To this effect, six field campaigns were carried out in four sampling sites during winter season targeting the collection of fish species. A total of 48 samples were collected. Individuals from seven different taxa (marine and estuarine were collected, although the assemblage was dominated by two estuarine species—the native Pomatoschistus sp. (goby and the NIS Fundulus heteroclitus (mummichog. Goby was the most abundant taxa in the majority of salt marsh habitats, except for one specific, marsh pool, where extreme environmental conditions were registered, namely high temperature and salinity. Such conditions may have boosted the intrusion of mummichog in this area. This species is well adapted to a wide range of abiotic factors enabling them to colonize habitats where no predators inhabit. Impacts of mummichog introduction in the Guadiana salt marsh area are still unpredictable since this is the first time they have been recorded in such high density. Nevertheless, in scenarios of increased anthropogenic pressure and, consequently, habitat degradation, there is a potential risk of mummichog spreading to other habitats and therefore competing for space and food resources with native species.

  13. Behavioral changes over time in post-traumatic stress disorder: Insights from a rat model of single prolonged stress.

    Science.gov (United States)

    Wu, Zhuoyun; Tian, Qing; Li, Feng; Gao, Junqiao; Liu, Yan; Mao, Meng; Liu, Jing; Wang, Shuyan; Li, Genmao; Ge, Dongyu; Mao, Yingqiu; Zhang, Wei; Liu, Zhaolan; Song, Yuehan

    2016-03-01

    Post-traumatic stress disorder (PTSD) is manifested as a persistent mental and emotional condition after potentially life-threatening events. Different animal models of PTSD have been developed for neuro-pathophysiology and pharmacological evaluations. A single prolonged stress (SPS) induced animal model has demonstrated to result in specific neuro-endocrinological dysregulation, and behavior abnormalities observed in PTSD. However, animal studies of PTSD have mostly been performed at one time point after SPS exposure. To better understand the development of PTSD-like behaviors in the SPS animal model, and to identify an optimal period of study, we examined depressive behavior, anxiety-like behavior, physical activity and body weight in SPS model rats for two weeks. Our results confirmed the SPS-induced PTSD-like behavior and physical activity observed in previous studies, and indicated that the most pronounced symptomatic behavior changes were observed on day 1 and 7 after SPS exposure, which may involve stress-induced acute hormone changes and unclear secondary neurobiological changes, respectively. These results provide a solid basis for further investigation into the neuro-pathophysiology of or neuropharmacology for PTSD using the SPS rat model. However, for chronic (pharmacological) studies longer than 7 days, a prolonged PTSD animal model should be developed, perhaps using enhanced stimulation. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. The role of order and disorder in thermal and material sciences part 2: Scientific world and new insights

    Directory of Open Access Journals (Sweden)

    Šesták Jaroslav

    2003-01-01

    Full Text Available The notion of heat is thoroughly analyzed and its historical links are search particularly with relation to both the Greek philosophy (Mile in print sians Pythagoreans, atomists, etc and the in the present day thermal physics. Fluctuation, spontaneity and chaos is discussed. Thermodynamics is reviewed in the relation to both the traditional development and the modern description of disequilibria (open systems. Effect of dissipation is shown often to provide new, self-organized structures. Exploitation of fire and its conscious use as a manufacturing power are analyzed in terms of generalized engines to act in the sense of as the information transducers. The part 2 reveals the impact of mathematics as explained on some simple cases showing development of basic ideas (vibration, topology, bifurcations etc. Earth thermal environment is discussed in relation to the existence of life (antropy principles. Alternative theory of reaction-diffusion model of the space-time is put in contrast with big bang hypothesis and related to the herewith-discussed specialty of self-catalyzed chemical reactions. The text gives a consistent view to various historical and modern concepts that emerged during the gradual understanding of order and disorder.

  15. Internet Communication Disorder and the structure of the human brain: initial insights on WeChat addiction.

    Science.gov (United States)

    Montag, Christian; Zhao, Zhiying; Sindermann, Cornelia; Xu, Lei; Fu, Meina; Li, Jialin; Zheng, Xiaoxiao; Li, Keshuang; Kendrick, Keith M; Dai, Jing; Becker, Benjamin

    2018-02-01

    WeChat represents one of the most popular smartphone-based applications for communication. Although the application provides several useful features that simplify daily life, a growing number of users spend excessive amounts of time on the application. This may lead to interferences with everyday life and even to addictive patterns of use. In the context of the ongoing discussion on Internet Communication Disorder (ICD), the present study aimed to better characterize the addictive potential of communication applications, using WeChat as an example, by examining associations between individual variations in tendencies towards WeChat addiction and brain structural variations in fronto-striatal-limbic brain regions. To this end levels of addictive tendencies, frequency of use and structural MRI data were assessed in n = 61 healthy participants. Higher tendencies towards WeChat addiction were associated with smaller gray matter volumes of the subgenual anterior cingulate cortex, a key region for monitoring and regulatory control in neural networks underlying addictive behaviors. Moreover, a higher frequency of the paying function was associated with smaller nucleus accumbens volumes. Findings were robust after controlling for levels of anxiety and depression. The present results are in line with previous findings in substance and behavioral addictions, and suggest a similar neurobiological basis in ICD.

  16. Effectiveness of Aerobic Exercise as an Augmentation Therapy for Inpatients with Major Depressive Disorder: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Shachar-Malach, Tal; Cooper Kazaz, Rena; Constantini, Naama; Lifschytz, Tzuri; Lerer, Bernard

    2015-01-01

    Physical exercise has been shown to reduce depressive symptoms when used in combination with antidepressant medication. We report a randomized controlled trial of aerobic exercise compared to stretching as an augmentation strategy for hospitalized patients with major depression. Male or female patients, 18-80 years, diagnosed with a Major Depressive Episode, were randomly assigned to three weeks of augmentation therapy with aerobic (n=6) or stretching exercise (n=6). Depression was rated, at several time points using the 21-item Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI) and other scales. According to the HAM-D, there were four (out of six) responders in the aerobic group, two of whom achieved remission, and none in the stretching group. According to the BDI, there were two responders in the aerobic group who were also remitters and none in the stretching group. The results of this small study suggest that aerobic exercise significantly improves treatment outcome when added to antidepressant medication. However, due to the small sample size the results must be regarded as preliminary and further studies are needed to confirm the findings.

  17. The value of midbrain morphology in predicting prognosis in chronic disorders of consciousness: A preliminary ultrasound study.

    Science.gov (United States)

    Chillura, Antonino; Naro, Antonino; Micchia, Katia; Bramanti, Alessia; Bramanti, Placido; Calabrò, Rocco Salvatore

    2017-09-15

    Transcranial sonography (TCS) of the brainstem is currently used to support the clinical diagnosis of movement disorders. The aim of the study was to assess the usefulness of midbrain TCS in assessing outcome in patients with Chronic Disorders of Consciousness (DOC). Eleven patients with Minimally Conscious State (MCS) and Unresponsive Wakefulness Syndrome (UWS) were included in the study. We measured the area and echogenicity of the midbrain by encoding and digitally analyzing the corresponding images from the orbitomeatal plane, the morphology of brain parenchyma from the thalamic and cella media plane, and the intracranial circulation. All the patients showed an increase of pulsatility index and numerous morphological alterations on all the scan planes. In particular, we found a loss of the characteristic butterfly-shape of the midbrain, which appeared hypoechoic in the UWS but not in the MCS patients. After six months, the patients were clinically assessed by using Glasgow Outcome Scale Extended (GOSE). We found that a higher increase in GOSE scoring at follow-up was correlated with larger area and higher echogenicity of the midbrain at baseline. The present study suggests that TCS data of the midbrain may support clinical assessment of patients with chronic DOC to estimate their outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: a preliminary study.

    Science.gov (United States)

    Souza, Juliana A; Pasinato, Fernanda; Corrêa, Eliane C R; da Silva, Ana Maria T

    2014-01-01

    The aim of this study was to evaluate body posture and the distribution of plantar pressure at physiologic rest of the mandible and during maximal intercuspal positions in subjects with and without temporomandibular disorder (TMD). Fifty-one subjects were assessed by the Diagnostic Criteria for Research on Temporomandibular Disorders and divided into a symptomatic group (21) and an asymptomatic group (30). Postural analysis for both groups was conducted using photogrammetry (SAPo version 0.68; University of São Paulo, São Paulo, Brazil). The distribution of plantar pressures was evaluated by means of baropodometry (Footwork software), at physiologic rest and maximal intercuspal positions. Of 18 angular measurements, 3 (17%) were statistically different between the groups in photogrammetric evaluation. The symptomatic group showed more pronounced cervical distance (P = .0002), valgus of the right calcaneus (P = .0122), and lower pelvic tilt (P = .0124). The baropodometry results showed the TMD subjects presented significantly higher rearfoot and lower forefoot distribution than those in the asymptomatic group. No differences were verified in maximal intercuspal position in the between-group analysis and between the 2 mandibular positions in the within-group analysis. Subjects with and without TMD presented with global body posture misalignment. Postural changes were more pronounced in the subjects with TMD. In addition, symptomatic subjects presented with abnormal plantar pressure distribution, suggesting that TMD may have an influence on the postural system. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  19. A survey of Korean medicine doctors' clinical practice patterns for autism spectrum disorder: preliminary research for clinical practice guidelines.

    Science.gov (United States)

    Lee, Jihong; Lee, Sun Haeng; Lee, Boram; Yang, In Jun; Chang, Gyu Tae

    2018-03-13

    The aim of this study was to investigate autism spectrum disorder (ASD) clinical practice patterns of Korean medicine doctors (KMDs) through questionnaire survey. Questionnaires on Korean medicine (KM) treatment for ASD were distributed to 255 KMDs on December 5, 2016. The KMDs were psychiatrists, pediatricians, or general practitioners, who treated patients with ASD. The questionnaire covered items on treatment methods, aims of treatment, KM syndrome differentiation, diagnostic tools, and sociodemographic characteristics. Frequency analysis was conducted to describe the participants and their practices. A total 22.4% KMDs (n = 57/255) completed the questionnaires and 54 KMDs (21.2%) matched the inclusion criteria. The KMDs utilized herbal medicine (27.3%), body acupuncture (17.6%), scalp acupuncture (10.7%), moxibustion (6.4%), and Korean medical psychotherapy (5.9%) to treat ASD. The most commonly prescribed herbal medicine was Yukmijihwang-tang. Forty-eight (88.9%) KMDs responded that they used KM syndrome differentiation. 'Organ system, Qi, Blood, Yin, Yang, Fluid and Humor diagnosis' was most frequently used for syndrome differentiation. ASD was mainly diagnosed based on the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and DSM-5. The present study demonstrated the current status of KMDs' diagnosis and treatment of ASD. In future clinical trials and clinical practice guidelines, these findings will provide meaningful information on the actual practice patterns of KMDs.

  20. Is panic disorder associated with clinical severity of fibromyalgia? A preliminary study in a tertiary-care centre.

    Science.gov (United States)

    Alciati, Alessandra; Caldirola, Daniela; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola; Grassi, Massimiliano; Perna, Giampaolo

    2016-01-01

    To investigate the influence of panic disorder (PD) with/without agoraphobia on the clinical severity of fibromyalgia (FM). Eighty-one patients with FM, among those consecutively referring to a tertiary-care setting, were included in this cross-sectional study. Psychiatric diagnoses were made by the structured clinical interview in accordance with the 4th-TR version of the diagnostic and statistical manual of mental disorders. The clinical severity of FM was measured by means of the following self-administered scales: Fibromyalgia Impact Questionnaire (FIQ), Fibromyalgia Assessment Status (FAS), Health Assessment Questionnaire (HAQ). A final sample of 66 females with FM with or without past PD was included in the analyses. The two groups did not significantly differ in age, years of education, length of illness or medication distribution. We did not find significant differences between the two groups in the FIQ and FAS scale scores, whereas subjects with FM and past PD showed significantly higher HAQ scale scores than those without past PD (p<.001). A history of PD in patients with FM increases the severity of functional impairment in performing a wide range of daily-life activities, as measured by the HAQ scale, with no effects on the severity of other clinical dimensions of FM. Potential underlying mechanisms and clinical implications will be discussed.

  1. Mindfulness moderates the relationship between aggression and Antisocial Personality Disorder traits: Preliminary investigation with an offender sample.

    Science.gov (United States)

    Velotti, Patrizia; Garofalo, Carlo; D'Aguanno, Mario; Petrocchi, Chiara; Popolo, Raffaele; Salvatore, Giampaolo; Dimaggio, Giancarlo

    2016-01-01

    Poor mentalizing has been described as a characteristic of Antisocial Personality Disorder (ASPD), along with the well-established role of aggressiveness. In the current study, we tested this hypothesis focusing on a specific aspect of mentalization (i.e., mindfulness). We explored the unique and joint contribution of aggression dimensions and mindfulness facets to ASPD traits in an offender sample (N=83). Mindfulness deficits were associated with ASPD traits, and a significant unique association emerged between difficulties in acting with awareness and ASPD traits. Likewise, physical aggression confirmed its association with ASPD traits. Moderation analyses revealed that mindfulness interacted with aggression in predicting ASPD. Specifically, at low levels of mindfulness, the association between aggression and ASPD dropped to nonsignificance. Results suggest that fostering self-mentalizing is a relevant treatment target when treating offenders with ASPD. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. A Preliminary Report of Short-Term Cognitive-Behavioral Group Therapy for Inpatients With Personality Disorders

    Science.gov (United States)

    SPRINGER, TAMAR; LOHR, NAOMI E.; BUCHTEL, HENRY A.; SILK, KENNETH R.

    1996-01-01

    A randomized, controlled study evaluated the effectiveness of a cognitive-behavioral therapy group, based on Linehan’s dialectical behavior therapy, for inpatients with personality disorders. The treatment, a problem-solving skills group focused on parasuicidality, was compared with a discussion control group. Change was assessed by self-report measures and behavioral observations on the unit. Subjects in both groups improved significantly on most change measures, although no significant between-group differences were found. However, the treatment group patients viewed the intervention as more beneficial to them in their lives outside the hospital. The usefulness of this type of group on a short-term unit is discussed. PMID:22700265

  3. Lack of association between obsessive-compulsive disorder and the dopamine D{sub 3} receptor gene: Some preliminary considerations

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, M.; Sciuto, G.; Di Bella, D. [Univ. of Milan Medical School (Italy)] [and others

    1994-09-15

    Controversial results possibly suggesting an association between Tourette`s syndrome (TS) and excess of homozygosity at an Msc I polymorphism in the Dopamine D{sub 3} receptor (DRD{sub 3}) gene have recently been reported. Since a relationship between obsessive-compulsive disorder (OCD) and Tourette`s syndrome (TS) has been suggested, in this study we assessed the frequency of this 2-allele polymorphism in a sample of 97 OCD patients and in 97 control subjects. No statistically significant differences in allele or genotype frequencies were found. Thus this mutation in the coding sequence of the DRD{sub 3} gene is unlikely to confer susceptibility to OCD. 28 refs., 21 tabs.

  4. Plasma glial cell line-derived neurotrophic factor in patients with major depressive disorder: a preliminary study.

    Science.gov (United States)

    Lee, Bun-Hee; Hong, Jin-Pyo; Hwang, Jung-A; Na, Kyoung-Sae; Kim, Won-Joong; Trigo, Jose; Kim, Yong-Ku

    2016-02-01

    Some clinical studies have reported reduced peripheral glial cell line-derived neurotrophic factor (GDNF) level in elderly patients with major depressive disorder (MDD). We verified whether a reduction in plasma GDNF level was associated with MDD. Plasma GDNF level was measured in 23 healthy control subjects and 23 MDD patients before and after 6 weeks of treatment. Plasma GDNF level in MDD patients at baseline did not differ from that in healthy controls. Plasma GDNF in MDD patients did not differ significantly from baseline to the end of treatment. GDNF level was significantly lower in recurrent-episode MDD patients than in first-episode patients before and after treatment. Our findings revealed significantly lower plasma GDNF level in recurrent-episode MDD patients, although plasma GDNF levels in MDD patients and healthy controls did not differ significantly. The discrepancy between our study and previous studies might arise from differences in the recurrence of depression or the ages of the MDD patients.

  5. Association Between Stress-Related Sleep Reactivity and Metacognitive Beliefs About Sleep in Insomnia Disorder: Preliminary Results.

    Science.gov (United States)

    Palagini, Laura; Bruno, Rosa Maria; Paolo, Toti; Caccavale, Lisa; Gronchi, Alessia; Mauri, Mauro; Riemann, Dieter; Drake, Christopher L

    2016-01-01

    To evaluate the relation between stress-related sleep reactivity and metacognitive beliefs about sleep in subjects with insomnia disorder (93) and in a group of healthy controls (30) a set of variables, including Ford Insomnia Response to Stress Test (FIRST) and Metacognition Questionnaire-Insomnia (MCQ-I), have been used. Internal consistency of the Italian version of FIRST was studied. Univariate correlation, regression analysis, and principal component analysis were also performed. The Italian version of FIRST showed good internal consistency and discriminant validity. Sleep reactivity was higher in women (p sleep (p sleep reactivity. Therapeutic strategies acting selectively on metacognition to reduce stress-related sleep reactivity in insomnia may be useful.

  6. Relationship between social-cognitive and social-perceptual aspects of theory of mind and neurocognitive deficits, insight level and schizotypal traits in obsessive-compulsive disorder.

    Science.gov (United States)

    Mısır, Emre; Bora, Emre; Akdede, Berna Binnur

    2018-05-01

    The primary aim of the current study was to investigate different aspects of theory of mind (ToM), including social-cognitive (ToM-reasoning) and social-perceptual (ToM-decoding) in obsessive-compulsive disorder (OCD). We also aimed to investigate the relationship between ToM, neurocognition and a number of clinical variables including overvalued ideas, schizotypal personality traits, level of insight, and disease severity. Thirty-four patients who have been diagnosed with OCD according to DSM-IV and 30 healthy controls were included in the study. All participants were given a neuropsychological battery including tasks measuring ToM-reasoning, ToM-decoding and other neurocognitive functions. Schizotypal Personality Questionnaire (SPQ), Yale Brown Obsession and Compulsion Scale (YBOC-S) and Overvalued Ideas Scale (OVIS) were also administered to the participants. Patients with OCD showed significant deficits in both aspects of ToM. ToM performances of patients showed a significant positive correlation with neurocognitive functions. When controlled for general cognition factor, patient-control difference for ToM-reasoning (F = 3,917; p = 0,05), but not ToM-decoding, remained statistically significant. ToM-reasoning impairment of patients was significantly related to the severity of OCD symptoms and poor insight (p = 0,026 and p = 0,045, respectively). On the other hand, general cognitive factor (β = 0,778; t = 3,146; p = 0,04) was found to be the only significant predictor of ToM-reasoning in OCD patients in the multiple linear regression model. OCD is associated with ToM impairment, which is related to schizotypal traits, disease severity and poor insight, yet neurocognitive deficits also significantly contribute to this finding. However, ToM-reasoning impairment could be considered as a relatively distinct feature of OCD, which is partly separate from general cognitive deficits. Copyright © 2018. Published by Elsevier Inc.

  7. Developing and Testing Twelve-Step Facilitation for Adolescents with Substance Use Disorder: Manual Development and Preliminary Outcomes

    Directory of Open Access Journals (Sweden)

    John F. Kelly

    2016-01-01

    Full Text Available Adolescent substance use disorder treatment programs are often based on the 12-step philosophy of Alcoholics Anonymous and/or link adolescents to these free resources. Despite this, no studies have developed and rigorously tested a twelve-step facilitation (TSF intervention for young people, leaving a significant evidence gap. This study describes the first systematic development of an outpatient adolescent TSF treatment. An integrated twelve-step facilitation (iTSF treatment incorporated TSF, motivational enhancement therapy, and cognitive behavioral therapy elements and was developed in an iterative manner with weekly feedback provided by 36 adolescents ( M age 17 years [SD = 1.4]; 52.8% white with DSM-IV substance use disorder recruited from the community. Assessments were conducted at baseline and at three and six months. Participants completed 6 of 10 sessions on average (8 participants completed all 10. Notable treatment developments were the inclusion of “in-services” led by Marijuana Anonymous members, including parents in a portion of individual sessions to provide a rationale for TSF, and use of a Socratic therapeutic interaction style. Acceptability and feasibility of the treatment were excellent (treatment satisfaction was 4.29 [SD = 0.59] out of 5. In keeping with TSF theory, the intervention substantially increased 12-step participation, and greater participation related to greater abstinence. iTSF is a replicable manualized treatment that can be implemented and tested in outpatient settings. Given the widespread compatibility of iTSF with the current adolescent treatment, if found efficacious, iTSF could be relatively easily adopted, implemented, and sustained and could provide an evidence-based option that could undergird current practice.

  8. INSIGHTS INTO THE PATHOLOGY OF THE α2-Na+/K+-ATPase IN NEUROLOGICAL DISORDERS; LESSONS FROM ANIMAL MODELS

    Directory of Open Access Journals (Sweden)

    Toke Jost Isaksen

    2016-05-01

    Full Text Available A functional Na+/K+-ATPase consists of a catalytic α subunit and a regulatory β subunit. Four α isoforms of the Na+/K+-ATPase are found in mammals, each with a unique expression pattern and catalytic activity. The α2 isoform, encoded by the ATP1A2 gene, is primarily found in the central nervous system (CNS and in heart-, skeletal- and smooth muscle tissues. In the CNS, the α2 isoform is mainly expressed in neuroglial cells. In particular, the α2 isoform is found in astrocytes, and is important for astrocytic K+ clearance and, consequently, the indirect uptake of neurotransmitters. Both processes are essential for proper brain activity, and autosomal dominantly mutations in the ATP1A2 gene cause the neurological disorder Familial hemiplegic migraine type 2 (FHM2. FHM2 is a severe subtype of migraine with aura that involving temporary numbness or weakness, and affecting only one side of the body. FHM2 patients often suffer from neurological comorbidities such as seizures, sensory disturbances, cognitive impairment and psychiatric manifestations. The functional consequences of FHM2 disease mutations leads to a partial or complete loss of function of pump activity; however a clear phenotype-genotype correlation has yet to be elucidated. Gene-modified mouse models targeting the Atp1a2 gene have proved instrumental in the understanding of the pathology of FHM2. Several Atp1a2 knockout (KO mice targeting different exons have been reported. Homozygous Atp1a2 KO mice die shortly after birth due to respiratory malfunction resulting from abnormal Cl- homeostasis in brainstem neurons. Heterozygous KO mice are viable, but display altered behavior and neurological deficits such as altered spatial learning, decreased motor activity and enhanced fear/anxiety compared to wild type mice. FHM2 knock-in (KI mouse models carrying the human in vivo disease mutations W887R and G301R have also been reported. Both models display altered cortical spreading

  9. Tipepidine in children with attention deficit/hyperactivity disorder: a 4-week, open-label, preliminary study

    Directory of Open Access Journals (Sweden)

    Sasaki T

    2014-01-01

    Full Text Available Tsuyoshi Sasaki,1,2 Kenji Hashimoto,3 Masumi Tachibana,1 Tsutomu Kurata,1 Keiko Okawada,1 Maki Ishikawa,1 Hiroshi Kimura,2 Hideki Komatsu,2 Masatomo Ishikawa,2 Tadashi Hasegawa,2 Akihiro Shiina,1 Tasuku Hashimoto,2 Nobuhisa Kanahara,3 Tetsuya Shiraishi,2 Masaomi Iyo1–31Department of Child Psychiatry, Chiba University Hospital, 2Department of Psychiatry, Chiba University Graduate School of Medicine, 3Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, JapanBackground: Tipepidine (3-[di-2-thienylmethylene]-1-methylpiperidine has been used solely as a nonnarcotic antitussive in Japan since 1959. The safety of tipepidine in children and adults has already been established. It is reported that tipepidine inhibits G-protein-coupled inwardly rectifying potassium (GIRK-channel currents. The inhibition of GIRK channels by tipepidine is expected to modulate the level of monoamines in the brain. We put forward the hypothesis that tipepidine can improve attention deficit/hyperactivity disorder (ADHD symptoms by modulating monoaminergic neurotransmission through the inhibition of GIRK channels. The purpose of this open-label trial was to confirm whether treatment with tipepidine can improve symptoms in pediatric patients with ADHD.Subjects and methods: This was a 4-week, open-label, proof-of-efficacy pilot study for pediatric subjects with ADHD. Ten pediatric ADHD subjects (70% male; mean age, 9.9 years; combined [inattentive and hyperactive/impulsive] subtype, n=7; inattentive subtype, n=3; hyperimpulsive subtype, n=0 received tipepidine hibenzate taken orally at 30 mg/day for 4 weeks. All subjects were assessed using the ADHD Rating Scale IV (ADHD-RS, Japanese version, and the Das–Naglieri Cognitive Assessment System (DN-CAS, Japanese version.Results: A comparison of baseline scores and 4-week end-point scores showed that all the ADHD-RS scores (total scores, hyperimpulsive subscores, and inattentive subscores

  10. Maudsley Bipolar Disorder Project: insights sobre o papel do córtex pré-frontal em pacientes com transtorno de humor bipolar tipo I Proyecto Maudsley para Trastorno Bipolar: insights sobre el rol del córtex prefrontal en casos de disturbio bipolar I The Maudsley Bipolar Disorder Project: insights into the role of the prefrontal cortex in bipolar disorder I

    Directory of Open Access Journals (Sweden)

    Morgan Haldane

    2005-12-01

    Full Text Available OBJETIVO: O projeto Maudsley Bipolar Disorder foi criado para investigar características cognitivas e estruturais/funcionais do cérebro em pacientes com Transtorno de Humor Bipolar Tipo I (THB-I. MÉTODOS: Quarenta e três pacientes com THB-I foram selecionados em uma unidade de atendimento secundário, em um momento de remissão da doença, para participarem do estudo. Os pacientes foram pareados a controles sadios de acordo com idade, sexo, raça e nível de escolaridade. Cada participante foi submetido a uma extensa revisão clínica, com avaliação cognitiva e exame de ressonância magnética (RM para a obtenção de dados estruturais e funcionais do cérebro. RESULTADOS: Quando comparados aos controles, os pacientes demonstraram um sutil e difuso comprometimento com redução mais marcante no nível das funções executivas. Os pacientes também apresentaram decrementos volumétricos no córtex pré-frontal ventral (CPFV bilateralmente e córtex pré-frontal dorsal (CPFD esquerdo. O volume da amígdala estava bilateralmente aumentado. A ressonância magnética funcional (RMf mostrou anormalidades sutis no CPFD, com marcados decrementos de atividade tanto no CPFD como no CPFV durante tarefas que dependiam da interação funcional dessas regiões. CONCLUSÕES: Os resultados sugerem que ocorrem traços de déficits em funções executivas em pacientes com THB-I, assim como alteração de estrutura e funcionamento do córtex pré-frontal.OBJETIVO: El proyecto Maudsley para Trastorno Bipolar fue creado para investigar características cognitivas y estructurales/funcionales del cerebro en pacientes con Trastorno Bipolar I (TBI. MÉTODOS: Cuarenta y tres pacientes con TBI han sido elegidos en una unidad de atención secundaria para participar del estudio, en un momento de remisión de la enfermedad. Los pacientes han sido pareados a controles sanos conforme a edad, sexo, raza y nivel de escolaridad. Cada participante ha sido sometido a una

  11. Cultural context, obsessive-compulsive disorder symptoms, and cognitions: a preliminary study of three Turkish samples living in different countries.

    Science.gov (United States)

    Yorulmaz, Orçun; Işık, Bilgen

    2011-04-01

    Previous research findings have suggested that recent cognitive accounts of obsessive-compulsive disorder (OCD) are valid across different cultural contexts for both clinical and nonclinical samples; however, there is evidence that cultural differences may have an impact on a number of cognitive variables. For this reason, immigration provides an exceptional opportunity for an examination of the role of cultural context in cognitions and possible changes in cultural characteristics. To this end, the present study examined the interrelationships between thought-action fusion, thought control strategies and OCD symptoms in three nonclinical samples, taking the immigration factor into consideration. Thus, the current study included three Turkish sample groups: those who remigrated to Turkey from Bulgaria, those still living in Bulgaria, and those that have always resided in Turkey. The findings of the study supported the role of thought and action fusion and control strategies in OCD symptoms in a cross-cultural context. To illustrate, worry, as a thought control strategy for OCD symptoms, was a common factor in all three sample groups. However, differences were also noted between the groups, despite having the same ethnic origin. Although they immigrated back to Turkey and have been living there for a considerable period of time, the Turkish remigrants retained similar characteristics to the respondents in Bulgaria on cognitions in general. Consequently, it may be suggested that cultural context might have a relative impact on certain correlates. A replication of these findings using different immigration groups and examining various cultural factors is strongly encouraged.

  12. Could combined sleep and pain evaluation be useful in the diagnosis of disorders of consciousness (DOC)? Preliminary findings.

    Science.gov (United States)

    Aricò, Irene; Naro, Antonino; Pisani, Laura Rosa; Leo, Antonino; Muscarà, Nunzio; De Salvo, Simona; Silvestri, Rosalia; Bramanti, Placido; Calabrò, Rocco Salvatore

    2016-01-01

    The diagnosis of Disorders of Consciousness (DOC) is still challenging. Indeed, ~ 40% of patients in vegetative state (VS) are misdiagnosed, suggesting the need of more appropriate diagnostic tools. Emerging data are showing that EEG, including sleep structure evaluation and multimodal evoked potential recording could be helpful in DOC diagnosis. Moreover, pain perception evaluation could further increase diagnosis accuracy in such individuals. Fourteen individuals with DOC, due to severe brain injury, were enrolled and admitted to the Intensive Neurorehabilitation Unit of the Research Institute. All patients were evaluated by means of the Coma Recovery Scale-Revised, a 24(hh)-polysomnography and a Laser Evoked Potential (LEP) paradigm. Clinically-defined patients in Minimally Consciousness State showed a more preserved sleep structure, physiologic hypnic figures and preserved REM/NREM sleep distribution than subjects in VS. LEP showed increased latencies and reduced amplitudes and were also detectable in patients with more structured sleep. The data support previous findings concerning the importance of sleep study in DOC diagnosis, with more specific neurophysiological paradigms. Interestingly, the findings shed some light on the possible correlations among global brain connectivity, sleep structure and pain perception, which are related to the activity of the wide thalamo-cortical and cortico-cortical networks underlying consciousness.

  13. Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results.

    Science.gov (United States)

    Reyes-López, Julian; Ricardo-Garcell, Josefina; Armas-Castañeda, Gabriela; García-Anaya, María; Arango-De Montis, Iván; González-Olvera, Jorge J; Pellicer, Francisco

    2018-01-01

    Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. NCT02273674

  14. Is plasma GABA level a biomarker of Post-Traumatic Stress Disorder (PTSD) severity? A preliminary study.

    Science.gov (United States)

    Trousselard, Marion; Lefebvre, Bertrand; Caillet, Lionel; Andruetan, Yann; de Montleau, Franck; Denis, Josiane; Canini, Frédéric

    2016-07-30

    An increased reactivity to the environment is observed in Post-Traumatic Stress Disorder (PTSD). It would be related to impairment of the Gamma Amino Butyric Acid (GABA) neurotransmission. The study aimed to evaluate plasma GABA concentration as a candidate for PTSD severity biomarker. This hypothesis was studied in 17 PTSD patients and 17 healthy Controls using classic and emotional Stroop paradigms. Plasma GABA concentrations were assessed before and after both Stroop tests to evaluate GABA basal tone and GABA reactivity (change in GABAp), respectively. During baseline, PTSD had lower plasma GABA concentrations than the Controls. After the Stroop conflicts GABA reactivity was also lower in PTSD than in the Controls. The GABA baseline tone was negatively correlated with the severity of the PTSD symptoms. This relation was only marginally observed for GABA reactivity. The results produced a trend due to the small size of the sample compared to the number of statistical results given. Altogether, the reduced GABA concentration observed in PTSD could be considered as a possible biomarker for PTSD severity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. GRIN2B Gene and Associated Brain Cortical White Matter Changes in Bipolar Disorder: A Preliminary Combined Platform Investigation

    Directory of Open Access Journals (Sweden)

    Carissa Nadia Kuswanto

    2013-01-01

    Full Text Available Abnormalities in glutamate signaling and glutamate toxicity are thought to be important in the pathophysiology of bipolar disorder (BD. Whilst previous studies have found brain white matter changes in BD, there is paucity of data about how glutamatergic genes affect brain white matter integrity in BD. Based on extant neuroimaging data, we hypothesized that GRIN2B risk allele is associated with reductions of brain white matter integrity in the frontal, parietal, temporal, and occipital regions and cingulate gyrus in BD. Fourteen patients with BD and 22 healthy controls matched in terms of age, gender and handedness were genotyped using blood samples and underwent diffusion tensor imaging. Compared to G allele, brain FA values were significantly lower in BD patients with risk T allele in left frontal region (P=0.001, right frontal region (P=0.002, left parietal region (P=0.001, left occipital region (P=0.001, right occipital region (P<0.001, and left cingulate gyrus (P=0.001. Further elucidation of the interactions between different glutamate genes and their relationships with such structural, functional brain substrates will enhance our understanding of the link between dysregulated glutamatergic neurotransmission and neuroimaging endophenotypes in BD.

  16. Preliminary Findings that a Targeted Intervention Leads to Altered Brain Function in Children with Fetal Alcohol Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Kelly Nash

    2017-12-01

    Full Text Available Children with fetal alcohol spectrum disorder (FASD exhibit behavioral dysregulation, executive dysfunction, and atypical function in associated brain regions. Previous research shows early intervention mitigates these outcomes but corresponding brain changes were not studied. Given the Alert® Program for Self-Regulation improves behavioral regulation and executive function in children with FASD, we asked if this therapy also improves their neural functioning in associated regions. Twenty-one children with FASD aged 8–12 years were randomized to the Alert®-treatment (TXT; n = 10 or waitlist-control (WL; n = 11 conditions. They were assessed with a Go-NoGo functional magnetic resonance imaging (fMRI paradigm before and after training or the wait-out period. Groups initially performed equivalently and showed no fMRI differences. At post-test, TXT outperformed WL on NoGo trials while fMRI in uncorrected results with a small-volume correction showed less activation in prefrontal, temporal, and cingulate regions. Groups also demonstrated different patterns of change over time reflecting reduced signal at post-test in selective prefrontal and parietal regions in TXT and increased in WL. In light of previous evidence indicating TXT at post-test perform similar to non-exposed children on the Go-NoGo fMRI paradigm, our findings suggest Alert® does improve functional integrity in the neural circuitry for behavioral regulation in children with FASD.

  17. Attention-deficit/hyperactivity disorder, delay discounting, and risky financial behaviors: A preliminary analysis of self-report data.

    Directory of Open Access Journals (Sweden)

    Theodore P Beauchaine

    Full Text Available Delay discounting-often referred to as hyperbolic discounting in the financial literature-is defined by a consistent preference for smaller, immediate rewards over larger, delayed rewards, and by failure of future consequences to curtail current consummatory behaviors. Previous research demonstrates (1 excessive delay discounting among individuals with attention-deficit/hyperactivity disorder (ADHD, (2 common neural substrates of delay discounting and hyperactive-impulsive symptoms of ADHD, and (3 associations between delay discounting and both debt burden and high interest rate borrowing. This study extends prior research by examining associations between ADHD symptoms, delay discounting, and an array of previously unevaluated financial outcomes among 544 individuals (mean age 35 years. Controlling for age, income, sex, education, and substance use, ADHD symptoms were associated with delay discounting, late credit card payments, credit card balances, use of pawn services, personal debt, and employment histories (less time spent at more jobs. Consistent with neural models of reward processing and associative learning, more of these relations were attributable to hyperactive-impulsive symptoms than inattentive symptoms. Implications for financial decision-making and directions for future research are discussed.

  18. Attention-deficit/hyperactivity disorder, delay discounting, and risky financial behaviors: A preliminary analysis of self-report data.

    Science.gov (United States)

    Beauchaine, Theodore P; Ben-David, Itzhak; Sela, Aner

    2017-01-01

    Delay discounting-often referred to as hyperbolic discounting in the financial literature-is defined by a consistent preference for smaller, immediate rewards over larger, delayed rewards, and by failure of future consequences to curtail current consummatory behaviors. Previous research demonstrates (1) excessive delay discounting among individuals with attention-deficit/hyperactivity disorder (ADHD), (2) common neural substrates of delay discounting and hyperactive-impulsive symptoms of ADHD, and (3) associations between delay discounting and both debt burden and high interest rate borrowing. This study extends prior research by examining associations between ADHD symptoms, delay discounting, and an array of previously unevaluated financial outcomes among 544 individuals (mean age 35 years). Controlling for age, income, sex, education, and substance use, ADHD symptoms were associated with delay discounting, late credit card payments, credit card balances, use of pawn services, personal debt, and employment histories (less time spent at more jobs). Consistent with neural models of reward processing and associative learning, more of these relations were attributable to hyperactive-impulsive symptoms than inattentive symptoms. Implications for financial decision-making and directions for future research are discussed.

  19. Preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans.

    Science.gov (United States)

    O'Haire, Marguerite E; Rodriguez, Kerri E

    2018-02-01

    Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. The addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy.

    Science.gov (United States)

    Amoroso, Timothy; Workman, Michael

    2016-07-01

    Since the wars in Iraq and Afghanistan, posttraumatic stress disorder (PTSD) has become a major area of research and development. The most widely accepted treatment for PTSD is prolonged exposure (PE) therapy, but for many patients it is intolerable or ineffective. ±3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has recently re-emerged as a new treatment option, with two clinical trials having been published and both producing promising results. However, these results have yet to be compared to existing treatments. The present paper seeks to bridge this gap in the literature. Often the statistical significance of clinical trials is overemphasized, while the magnitude of the treatment effects is overlooked. The current meta-analysis aims to provide a comparison of the cumulative effect size of the MDMA-AP studies with those of PE. Effect sizes were calculated for primary and secondary outcome measures in the MDMA-AP clinical trials and compared to those of a meta-analysis including several PE clinical trials. It was found that MDMA-AP had larger effect sizes in both clinician-observed outcomes than PE did (Hedges' g=1.17 vs. g=1.08, respectively) and patient self-report outcomes (Hedges' g=0.87 vs. g=0.77, respectively). The dropout rates of PE and MDMA-AP were also compared, revealing that MDMA-AP had a considerably lower percentage of patients dropping out than PE did. These results suggest that MDMA-AP offers a promising treatment for PTSD. © The Author(s) 2016.

  1. Preliminary experience on the use of PET/CT in the management of pediatric post-transplant lymphoproliferative disorder.

    Science.gov (United States)

    Guerra-García, Pilar; Hirsch, Steffen; Levine, Daniel S; Taj, Mary M

    2017-12-01

    Post-transplant lymphoproliferative disorder (PTLD) is a well-known complication following prolonged immunosuppression. Contrary to other lymphomas, there is no standardized imaging approach to assess PTLD either at staging or for response to therapy. Positron emission tomography/computed tomography (PET/CT) is an imaging modality that has proven to be useful in lymphoma. However, there is still limited data concerning its use in pediatric PTLD. Our study evaluates the use of PET/CT in pediatric PTLD at our institution. To assess the role of PET/CT in pediatric PTLD, we reviewed the pediatric patients with PTLD who had undergone PET/CT at our institution between 2000 and 2016. Nine patients were identified. Six had PET/CT at diagnosis. All lesions seen on CT were identified with PET/CT. Fourteen PET/CTs were done during treatment. Eight PET/CTs were negative, including three where CT showed areas of uncertain significance. In these cases, PET/CT helped us to stop treatment and the patients remain in remission after a long follow-up (mean 74.3 months; range 12.4-180.9 months). PET/CT revealed additional disease in two cases, therefore treatment was intensified. Six biopsies and close follow-up was done to confirm PET/CT results. In one case, PET/CT did not identify central nervous system involvement demonstrated on magnetic resonance imaging. PET/CT may have an important role in the staging and follow-up of pediatric PTLD. In our cohort, PET/CT was helpful in staging and assessing treatment response and in clarifying equivocal findings on other imaging modalities. © 2017 Wiley Periodicals, Inc.

  2. Increase in IL-6 levels among major depressive disorder patients after a 6-week treatment with duloxetine 60 mg/day: a preliminary observation

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2011-02-01

    Full Text Available Michele Fornaro1, Matteo Martino1, Florinda Battaglia2, Salvatore Colicchio3, Giulio Perugi41Department of Neuroscience, Section of Psychiatry, University of Genova, Genoa, Italy; 2Center of Excellence for Biomedical Research (CEBR, Genoa, Italy; 3Department of Neurosciences, Catholic University, Rome, Italy; 4Department of Psychiatry, Institute of Behavioral Sciences, University of Pisa, Pisa, ItalyBackground: Immune modifications, including changes in interleukin (IL-6 levels, have often been observed in major depressive disorder (MDD during treatment with selective serotonin reuptake inhibitors (SSRIs or the serotonin norepinephrine reuptake inhibitor (SNRI venlafaxine. Nevertheless, no equivalent observation for the SNRI duloxetine has been made to date.Method: Sixteen patients diagnosed with MDD and an actual major depressive episode according to DSM-IV criteria and 16 healthy controls entered a 6-week trial with duloxetine 60 mg/day. All subjects (n = 32 were assessed using the Hamilton Depression Rating Scale (HAM-D, the Young Mania Rating Scale (YMRS, and were monitored for IL-6 levels both at baseline and at week 6. Blood samples for IL-6 levels were evaluated by ELISA.Results: After 6 weeks of treatment, the mean total scores for HAM-D declined both in the depressed and control groups, while IL-6 modification showed an opposite trend both in depressed (12.38 ± 19.80 to 19.73 ± 18.94 pg/mL and control subjects (12.25 ± 21.12 to 17.63 ± 20.44 pg/mL, as did YMRS (ns, although none of the subjects switched to (hypomania. Of note, IL-6 levels increased significantly only in the responders subgroup (n = 9; P = 0.012.Conclusion: The small sample size and weak design of this study limit the validity of our results, which should be regarded as preliminary only. Nonetheless, the trend of increasing IL-6 levels observed in responder patients treated with duloxetine should prompt further controlled, extended studies with larger samples, with

  3. Stigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders

    NARCIS (Netherlands)

    Staring, A.B.P.; van der Gaag, M.; van den Berge, M.; Duivenvoorden, H.J.; Mulder, C.L.

    2009-01-01

    Abstract Background Good insight into illness in patients with schizophrenia is related not only to medication compliance and high service engagement, but also to depression, low self-esteem, and low quality of life. The detrimental effects of insight pose a problem for treatment. Aim To investigate

  4. Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action.

    Science.gov (United States)

    Meiser-Stedman, Richard; Smith, Patrick; McKinnon, Anna; Dixon, Clare; Trickey, David; Ehlers, Anke; Clark, David M; Boyle, Adrian; Watson, Peter; Goodyer, Ian; Dalgleish, Tim

    2017-05-01

    Few efficacious early treatments for post-traumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post-trauma and focused on secondary prevention of later post-traumatic stress; however, considerable natural recovery may still occur up to 6-months post-trauma. No trials have addressed the early treatment of established PTSD (i.e. 2- to 6-months post-trauma). Twenty-nine youth (8-17 years) with PTSD (according to age-appropriate DSM-IV or ICD-10 diagnostic criteria) after a single-event trauma in the previous 2-6 months were randomly allocated to Cognitive Therapy for PTSD (CT-PTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. Significantly more participants were free of PTSD after CT-PTSD (71%) than WL (27%) at posttreatment (intent-to-treat, 95% CI for difference .04-.71). CT-PTSD yielded greater improvement on child-report questionnaire measures of PTSD, depression and anxiety; clinician-rated functioning; and parent-reported outcomes. Recovery after CT-PTSD was maintained at 6- and 12-month posttreatment. Beneficial effects of CT-PTSD were mediated through changes in appraisals and safety-seeking behaviours, as predicted by cognitive models of PTSD. CT-PTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. This trial provides preliminary support for the efficacy and acceptability of CT-PTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of 'watchful waiting' into the 2- to 6-month post-trauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

  5. [Poor insight and psychosis].

    Science.gov (United States)

    Giotakos, O

    2017-01-01

    A variety of phenomena might be considered as reflecting impaired insight in psychosis, like failure to recognize signs, symptoms or disease, failure to derive appropriate cognitive representations, despite recognition of the disease, and misattribution of the source or cause of the disease. The unawareness of tardive dyskinesia symptoms in schizophrenic patients points that self-awareness deficits in schizophrenia may be domain specific. Poor insight is an independent phenomenological and a prevalent feature in psychotic disorders in general, and in schizophrenia in particular, but we don't know yet if delusions in schizophrenia are the result of an entirely normal attempt to account for abnormal perceptual experiences or a product of abnormal experience but of normal reasoning. The theoretical approaches regarding impaired insight include the disturbed perceptual input, the impaired linkage between thought and emotion and the breakdown of the process of self-monitoring and error checking. The inability to distinguish between internally and externally generated mental events has been described by the metarepresentation theory. This theory includes the awareness of ones' goals, which leads to disorders of willed action, the awareness of intention, which leads to movement disorders, and the awareness of intentions of others, which leads to paranoid delusions. The theory of metarepresentation implies mainly output mechanisms, like the frontal cortex, while the input mechanism implies posterior brain systems, including the parietal lobe. There are many similarities between the disturbances of awareness seen in schizophrenia and those seen as a result of known neurological impairment. Neuropsychological models of impaired insight typically attribute the disturbance to any of a variety of core deficits in the processing of information. In this respect, lack of insight is on conceptual par with alogia, apraxia or aphasia in reflecting disturbed cognitive processing. In

  6. Memory-Focused Cognitive Therapy for Cocaine Use Disorder: Theory, Procedures and Preliminary Evidence From an External Pilot Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    John Marsden

    2018-03-01

    Full Text Available Background: Cocaine use disorder (CUD is a debilitating condition with no NICE-recommended medication or specific psychosocial interventions. In the United Kingdom (UK, general counselling (treatment-as-usual; TAU is widely delivered, but has limited effectiveness. We tested the feasibility, safety and preliminary efficacy of a novel, adjunctive psychosocial intervention for CUD, called ‘memory-focused cognitive therapy’ (MFCT. Methods: We did a two-arm, external pilot randomised controlled trial at a specialist community National Health Service addictions clinic in London, UK. 30 adults (≥18 years, voluntarily seeking treatment for CUD (enrolled ≥14 days; all with moderate-to-severe DSM5 CUD, were individually randomised (1:1 to a control group (ongoing TAU; 3 × 90 min CUD cognitive conceptualisation assessments; 2 × 30 min cocaine-related cue-induction procedures; and 3 × 30 min research follow-ups; or to an intervention group (ongoing TAU; 3 × 90 min cognitive conceptualisation assessments; 2 × 30 min cocaine-related cue-induction procedures; 5 × 120 min, one-to-one, MFCT sessions [in 1 week]; and 3 × 60 min research follow-ups and MFCT-relapse prevention.The primary outcome was the total percentage score on the frequency version of the Craving Experiences Questionnaire (CEQ-F at 1-month follow-up after the intensive intervention week (clinical endpoint; recall period past 2 weeks; higher score indicating greater craving. Secondary outcomes at the 1-month follow-up were percentage days abstinent (PDA from cocaine, and longest period (days of continuous abstinence (LPA in the prior 28 days.Outcomes were analysed as an unadjusted group mean difference (with Hedge's g effect size [ES] and a 95% Confidence Interval [CI] for the primary outcome and a 90% CI for the secondary outcomes. Exploratory, multivariable linear (primary outcome and Poisson regression models (secondary outcomes, with sex, age, months

  7. A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women with Body Image Concerns

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather

    2012-01-01

    Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and…

  8. Reliability and validity of the Turkish version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D): a preliminary study.

    Science.gov (United States)

    Kundakçi, Turgut; Sar, Vedat; Kiziltan, Emre; Yargiç, Ilhan L; Tutkun, Hamdi

    2014-01-01

    A total of 34 consecutive patients with dissociative identity disorder or dissociative disorder not otherwise specified were evaluated using the Turkish version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). They were compared with a matched control group composed of 34 patients who had a nondissociative psychiatric disorder. Interrater reliability was evaluated by 3 clinicians who assessed videotaped interviews conducted with 5 dissociative and 5 nondissociative patients. All subjects who were previously diagnosed by clinicians as having a dissociative disorder were identified as positive, and all subjects who were previously diagnosed as not having a dissociative disorder were identified as negative. The scores of the main symptom clusters and the total score of the SCID-D differentiated dissociative patients from the nondissociative group. There were strong correlations between the SCID-D and the Dissociative Experiences Scale total and subscale scores. These results are promising for the validity and reliability of the Turkish version of the SCID-D. However, as the present study was conducted on a predominantly female sample with very severe dissociation, these findings should not be generalized to male patients, to dissociative disorders other than dissociative identity disorder, or to broader clinical or nonclinical populations.

  9. Preliminary evidence for association of genetic variants in pri-miR-34b/c and abnormal miR-34c expression with attention deficit and hyperactivity disorder.

    Science.gov (United States)

    Garcia-Martínez, I; Sánchez-Mora, C; Pagerols, M; Richarte, V; Corrales, M; Fadeuilhe, C; Cormand, B; Casas, M; Ramos-Quiroga, J A; Ribasés, M

    2016-08-30

    Attention deficit and hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by impairment to sustain attention and inability to control impulses and activity level. The etiology of ADHD is complex, with an estimated heritability of 70-80%. Under the hypothesis that alterations in the processing or target binding of microRNAs (miRNAs) may result in functional alterations predisposing to ADHD, we explored whether common polymorphisms potentially affecting miRNA-mediated regulation are involved in this psychiatric disorder. We performed a comprehensive association study focused on 134 miRNAs in 754 ADHD subjects and 766 controls and found association between the miR-34b/c locus and ADHD. Subsequently, we provided preliminary evidence for overexpression of the miR-34c-3p mature form in peripheral blood mononuclear cells of ADHD subjects. Next, we tested the effect on gene expression of single-nucleotide polymorphisms within the ADHD-associated region and found that rs4938923 in the promoter of the pri-miR-34b/c tags cis expression quantitative trait loci for both miR-34b and miR-34c and has an impact on the expression levels of 681 transcripts in trans, including genes previously associated with ADHD. This gene set was enriched for miR-34b/c binding sites, functional categories related to the central nervous system, such as axon guidance or neuron differentiation, and serotonin biosynthesis and signaling canonical pathways. Our results provide preliminary evidence for the contribution to ADHD of a functional variant in the pri-miR-34b/c promoter, possibly through dysregulation of the expression of mature forms of miR-34b and miR-34c and some target genes. These data highlight the importance of abnormal miRNA function as a potential epigenetic mechanism contributing to ADHD.

  10. Types ofpsychomotor developmental disorders inchildren before theage of3 years and the meaning of the early intervention for thechild’s future development – preliminary research

    Directory of Open Access Journals (Sweden)

    Anna Klimek

    2012-09-01

    Full Text Available Aim of the study: The analysis of the types of developmental disorders in early childhood. Material and methods: Seventy-one children at the age from 7 days to 3 years who came to The Early Intervention Centre for Handicapped Children “Give the Chance” at University Children’s Clinical Hospital in Bialystok in 2010 were examined. There were 46 (65% boys and 25 (35% girls in that group. The most common reason for coming to the Centre was the psychomotor retardation – 38 (54% subjects. In the Centre the diagnosis included: developmental interview, psychological, pedagogical and speech-therapy research. The evaluation of the psychomotor development in the psychological investigation was made using the Brunet-Lézine Scale of Psychomotor Development. The opinion on the symptoms of pervasive developmental disorder was based on diagnostic criteria contained in ICD-10. Results: The delayed development of the active speech was diagnosed in 71 (100% subjects. Forty-one (58% patients had psychomotor retardation without the features of the pervasive developmental disorder. Pervasive developmental disorder was diagnosed in 19 (27% subjects. The quotient of the psychomotor development was 77. Therapeutic influences included: psychoeducation – 65 (92% subjects, pedagogical therapy and speech-therapy – 13 (18% subjects, emotional support – 65 (92% subjects, systematic group classes for parents – 10 (14% subjects. Conclusions: 1 The developmental disorder was diagnosed in the majority of the examined children – 41 (58% subjects. 2 Pervasive developmental disorder was diagnosed in 19 (27% subjects, which is in accordance with the worldwide tendency for the growth of the number of diagnosis connected with this disorder (“autism epidemics”.

  11. Insight in schizophrenia: a review.

    Science.gov (United States)

    Dam, Jesper

    2006-01-01

    The issue of insight in schizophrenia must be assumed to be one of the most important aspects of the clinical examination. Comprehensive studies have shown that between 50% and 80% of all patients suffering from schizophrenia do not believe that they have a disorder. In recent years, poor insight in schizophrenia has been the subject of increasing interest, as manifested in a number of studies discussed in the present review. Some of these studies focus on insight correlated to various parameters such as psychopathology, neuropsychology, clinical relevance and compliance. Other studies refer to more theoretical implications, among these the issue of defining the concept of insight: whether insight can be seen as a "primary" phenomenon in schizophrenia, and whether insight may be graduated, dimensioned or increased. Several authors have developed rating scales in an attempt to obtain a measure for the degree or dimension of insight. Here, the range of parameters employed gives an excellent impression of the complexity of the concept of insight. In the concluding discussion, a phenomenological aspect is brought in, in an attempt to place the concept of insight in relation to disturbances of the self in schizophrenia and to primary symptoms in schizophrenia, amongst these autism.

  12. Africa Insight

    African Journals Online (AJOL)

    Africa Insight is a quarterly, peer-reviewed journal of the Africa Institute of South Africa. It is accredited by the South African National Department of Higher Education and Training (DHET) and is indexed in the International Bibliography of Social Science (IBSS). It is a multi-disciplinary journal primarily focusing on African ...

  13. Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy.

    Science.gov (United States)

    Santos, Veruska Andrea; Freire, Rafael; Zugliani, Morená; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia

    2016-03-22

    The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (Paddiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (Panxiety, the correlation between scores was .724. This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the

  14. Targeting brain serotonin synthesis: insights into neurodevelopmental disorders with long-term outcomes related to negative emotionality, aggression and antisocial behaviour.

    Science.gov (United States)

    Lesch, Klaus-Peter; Araragi, Naozumi; Waider, Jonas; van den Hove, Daniel; Gutknecht, Lise

    2012-09-05

    Aggression, which comprises multi-faceted traits ranging from negative emotionality to antisocial behaviour, is influenced by an interaction of biological, psychological and social variables. Failure in social adjustment, aggressiveness and violence represent the most detrimental long-term outcome of neurodevelopmental disorders. With the exception of brain-specific tryptophan hydroxylase-2 (Tph2), which generates serotonin (5-HT) in raphe neurons, the contribution of gene variation to aggression-related behaviour in genetically modified mouse models has been previously appraised (Lesch 2005 Novartis Found Symp. 268, 111-140; Lesch & Merschdorf 2000 Behav. Sci. Law 18, 581-604). Genetic inactivation of Tph2 function in mice led to the identification of phenotypic changes, ranging from growth retardation and late-onset obesity, to enhanced conditioned fear response, increased aggression and depression-like behaviour. This spectrum of consequences, which are amplified by stress-related epigenetic interactions, are attributable to deficient brain 5-HT synthesis during development and adulthood. Human data relating altered TPH2 function to personality traits of negative emotionality and neurodevelopmental disorders characterized by deficits in cognitive control and emotion regulation are based on genetic association and are therefore not as robust as the experimental mouse results. Mouse models in conjunction with approaches focusing on TPH2 variants in humans provide unexpected views of 5-HT's role in brain development and in disorders related to negative emotionality, aggression and antisocial behaviour.

  15. Differences in functional activity between boys with pure oppositional defiant disorder and controls during a response inhibition task: a preliminary study.

    Science.gov (United States)

    Zhu, Yan; Ying, Kui; Wang, Ji; Su, Linyan; Chen, Jingyuan; Lin, Fan; Cai, Dongyang; Zhou, Ming; Wu, Daxing; Guo, Courtney; Wang, Shi

    2014-12-01

    Functional Magnetic Resonance Imaging (fMRI) of inhibitory control has only been investigated in patients with attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD). The objective of this study was to investigate the differences of functional areas associated with inhibitory control between boys with pure oppositional defiant disorder (ODD) and controls during a response inhibition task using functional magnetic resonance imaging (fMRI). Eleven boys with pure ODD and ten control boys, aged 10 to 12, performed a GoStop response inhibition task in this study. The task has a series of "go" trials to establish a pre-potent response tendency and a number of "stop" trials to test subjects' ability to withhold their responses. During the GoStop task, greater activation in the dorsolateral parts of the bilateral inferior frontal gyrus, left middle frontal gyrus (lMFG) and right superior frontal gyrus (rSFG) activation was seen in the ODD boys. Additionally, reduced activation in regions of the right inferior frontal gyrus (rIFG) was seen in the ODD boys in comparison with the control group. The results may suggest that the higher activation in areas adjacent to the rIFG could be the cause of reduced activation in the rIFG; although this is speculative and requires additional supporting evidence. The findings further suggest that ODD is a less pronounced functional disorder compared to ADHD and CD.

  16. Assessing the Job-Related Social Skills of Adolescents and Young Adults with Behavioral Disorders: Development and Preliminary Psychometric Characteristics of Two Measures.

    Science.gov (United States)

    Bullis, Michael; And Others

    This report describes the development and testing of two measures of job-related social behavior of adolescents and young adults, ages 14-21, with behavior disorders (BD). Following an introduction of the concept of job-related social behavior, detailed descriptive information and data are provided on development and field testing of the…

  17. Speech Perception and Phonological Short-Term Memory Capacity in Language Impairment: Preliminary Evidence from Adolescents with Specific Language Impairment (SLI) and Autism Spectrum Disorders (ASD)

    Science.gov (United States)

    Loucas, Tom; Riches, Nick Greatorex; Charman, Tony; Pickles, Andrew; Simonoff, Emily; Chandler, Susie; Baird, Gillian

    2010-01-01

    Background: The cognitive bases of language impairment in specific language impairment (SLI) and autism spectrum disorders (ASD) were investigated in a novel non-word comparison task which manipulated phonological short-term memory (PSTM) and speech perception, both implicated in poor non-word repetition. Aims: This study aimed to investigate the…

  18. Cohesion to the Group and Its Association with Attendance and Early Treatment Response in an Adult Day-Hospital Program for Eating Disorders: A Preliminary Clinical Investigation

    Science.gov (United States)

    Crino, Natalie; Djokvucic, Ivana

    2010-01-01

    Treatment outcome studies demonstrate that day-hospital programs are effective in the treatment of eating disorders. Few descriptions are available on the specifics of treatment, particularly the process of therapy. The group therapy modality is thought to provide important therapeutic benefits. The present study aimed to examine the association…

  19. Attentional Performance in Children and Adolescents with Tic Disorder and Co-Occurring Attention-Deficit/Hyperactivity Disorder: New Insights from a 2 × 2 Factorial Design Study

    OpenAIRE

    Greimel, Ellen; Wanderer, Sina; Rothenberger, Aribert; Herpertz-Dahlmann, Beate; Konrad, Kerstin; Roessner, Veit

    2011-01-01

    The aim of the present study was to investigate the effect of both tic disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) on attentional functions. N = 96 children and adolescents participated in the study, including n = 21 subjects with TD, n = 23 subjects with ADHD, n = 25 subjects with TD+ADHD, and n = 27 controls. Attentional performance was tested based on four computerized attention tasks (sustained attention, divided attention, go/nogo and set shifting). The effect of TD...

  20. Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

    Science.gov (United States)

    Krakow, Barry; Ulibarri, Victor A

    2013-03-01

    Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

  1. Cognitive insight: A systematic review.

    Science.gov (United States)

    Van Camp, L S C; Sabbe, B G C; Oldenburg, J F E

    2017-07-01

    Cognitive insight is the ability to re-evaluate thoughts and beliefs in order to make thoughtful conclusions. It differs from clinical insight, as it focuses on more general metacognitive processes. Therefore, it could be relevant to diverse disorders and non-clinical subjects. There is a growing body of research on cognitive insight in individuals with and without psychosis. This review has summarised the current state of the art regarding this topic. We conclude that while cognitive insight in its current form seems valid for use in individuals with psychosis, it is less so for individuals without psychosis. Additionally, higher cognitive insight not always leads to better psychological functioning. For instance, higher levels of self-reflection are often associated with depressive mood. We therefore recommend the sub-components of cognitive insight to be studied separately. Also, it is unclear what position cognitive insight takes within the spectrum of metacognitive processes and how it relates to other self-related concepts that have been defined previously in literature. Combining future and past research on cognitive insight and its analogue concepts will help in the formation of a uniform definition that fits all subjects discussed here. Copyright © 2017. Published by Elsevier Ltd.

  2. A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder.

    Science.gov (United States)

    Rosa-Alcázar, Ana I; Iniesta-Sepúlveda, Marina; Storch, Eric A; Rosa-Alcázar, Ángel; Parada-Navas, José L; Olivares Rodríguez, José

    2017-01-15

    Cognitive-Behavioral Family-Based Treatment (CBFT) is the standard of care in young children with OCD. Developmental considerations, parent desires, and cost-effective advantages motivate research to explore the relative efficacy of parent-only interventions. The main goal in this study was to test the effectiveness and feasibility of a parent only intervention for OCD in young children, comparing, in a preliminary fashion the relative efficacy of reducing obsessive-compulsive symptoms through two treatment conditions: 1) an individual CBFT for early OCD involving both parents and children, and 2) the family component of the intervention involving only individual Parent Training (PT). Twenty treatment-seeking families from two private outpatient clinics in Spain were alternately assigned to one of the two treatment conditions. Participants had a primary diagnosis of OCD and a mean age of 6.62 years (65% males). Interventions were conducted by the same therapist and the assessments were administered by independent clinicians who were blind to the experimental conditions of the participants. Assessment time-points were pretreatment, posttreatment, and 3-month follow-up (including diagnosis, symptom severity, global functioning, family accommodation, externalizing and internalizing symptoms, and satisfaction measures). The two ways of implementation, involving child and parents (CBFT) or involving only parents (PT), produced clinical improvements and were well-accepted by parents and children. The CBFT condition was superior to the PT condition in reducing externalizing problems. reduced sample size and absence of randomization were the main limitations of this study. these results suggest, in a preliminary manner, that the need to have the child present at session with the clinician could be decreased for some children, as well as the overall feasibility of working only with parents for the implementation of CBT for OCD in very young children. Copyright © 2016

  3. Catechol-O-methyltransferase Val158Met genotype in healthy and personality disorder individuals: Preliminary results from an examination of cognitive tests hypothetically differentially sensitive to dopamine functions

    Directory of Open Access Journals (Sweden)

    Winnie W Leung

    2007-01-01

    Full Text Available Winnie W Leung1, Margaret M McClure1, Larry J Siever1,2, Deanna M Barch3, Philip D Harvey1,21Department of Veterans Affairs, VISN 3 Mental Illness Research, Education, and Clinical Center (MIRECC, Bronx, NY, USA; 2Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY, USA; 3Departments of Psychology and Psychiatry, Washington University, St. Louis, MO, USAAbstract: A functional polymorphism of the gene coding for Catechol-O-methyltrasferase (COMT, an enzyme responsible for the degradation of the catecholamine dopamine (DA, epinephrine, and norepinephrine, is associated with cognitive deficits. However, previous studies have not examined the effects of COMT on context processing, as measured by the AX-CPT, a task hypothesized to be maximally relevant to DA function. 32 individuals who were either healthy, with schizotypal personality disorder, or non-cluster A, personality disorder (OPD were genotyped at the COMT Val158Met locus. Met/Met (n = 6, Val/Met (n = 10, Val/Val (n = 16 individuals were administered a neuropsychological battery, including the AX-CPT and the N-back working memory test. For the AX-CPT, Met/Met demonstrated more AY errors (reflecting good maintenance of context than the other genotypes, who showed equivalent error rates. Val/Val demonstrated disproportionately greater deterioration with increased task difficulty from 0-back to 1-back working memory demands as compared to Met/Met, while Val/Met did not differ from either genotypes. No differences were found on processing speed or verbal working memory. Both context processing and working memory appear related to COMT genotype and the AX-CPT and N-back may be most sensitive to the effects of COMT variation.Keywords: COMT, dopamine, context processing, working memory, schizotypal personality disorder

  4. Interaction between cannabis consumption and childhood abuse in psychotic disorders: preliminary findings on the role of different patterns of cannabis use.

    Science.gov (United States)

    Sideli, Lucia; Fisher, Helen L; Murray, Robin M; Sallis, Hannah; Russo, Manuela; Stilo, Simona A; Paparelli, Alessandra; Wiffen, Benjamin D R; O'Connor, Jennifer A; Pintore, Sonia; Ferraro, Laura; La Cascia, Caterina; La Barbera, Daniele; Morgan, Craig; Di Forti, Marta

    2018-04-01

    Several studies have suggested that lifetime cannabis consumption and childhood abuse synergistically contribute to the risk for psychotic disorders. This study aimed to extend existing findings regarding an additive interaction between childhood abuse and lifetime cannabis use by investigating the moderating role of type and frequency of cannabis use. Up to 231 individuals presenting for the first time to mental health services with psychotic disorders and 214 unaffected population controls from South London, United Kingdom, were recruited as part of the Genetics and Psychosis study. Information about history of cannabis use was collected using the Cannabis Experiences Questionnaire. Childhood physical and sexual abuse was assessed using the Childhood Experience of Care and Abuse Questionnaire. Neither lifetime cannabis use nor reported exposure to childhood abuse was associated with psychotic disorder when the other environmental variable was taken into account. Although the combination of the two risk factors raised the odds for psychosis by nearly three times (adjusted OR = 2.94, 95% CI: 1.44-6.02, P = 0.003), no evidence of interaction was found (adjusted OR = 1.46, 95% CI: -0.54 to 3.46, P = 0.152). Furthermore, the association of high-potency cannabis and daily consumption with psychosis was at least partially independent of the effect of childhood abuse. The heavy use of high-potency cannabis increases the risk of psychosis but, in addition, smoking of traditional resin (hash) and less than daily cannabis use may increase the risk for psychosis when combined with exposure to severe childhood abuse. © 2015 Wiley Publishing Asia Pty Ltd.

  5. Types ofpsychomotor developmental disorders inchildren before theage of3 years and the meaning of the early intervention for thechild’s future development – preliminary research

    OpenAIRE

    Anna Klimek; Anna Górska; Marzenna Radecka; Emilia Podgórska; Ewa Zarzecka

    2012-01-01

    Aim of the study: The analysis of the types of developmental disorders in early childhood. Material and methods: Seventy-one children at the age from 7 days to 3 years who came to The Early Intervention Centre for Handicapped Children “Give the Chance” at University Children’s Clinical Hospital in Bialystok in 2010 were examined. There were 46 (65%) boys and 25 (35%) girls in that group. The most common reason for coming to the Centre was the psychomotor retardation – 38 (54%) sub...

  6. Marijuana use is associated with inattention in men and sleep quality in women with Attention-Deficit/Hyperactivity Disorder: a preliminary study.

    Science.gov (United States)

    Ly, Christine; Gehricke, Jean-G

    2013-12-30

    The study examined the association between marijuana use, Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, and sleep quality in 56 men and 20 women with ADHD. Participants, ages 18-45, were assessed with the Assessment of Hyperactivity and Attention, drug use survey, and Pittsburgh Sleep Quality Index. Moderate to strong correlations were found between marijuana use and inattentive symptoms in men, and marijuana use and decreased sleep quality in women. Men and women with ADHD may use marijuana for different reasons. © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Outcome predictors in autism spectrum disorders preschoolers undergoing treatment as usual: insights from an observational study using artificial neural networks

    Directory of Open Access Journals (Sweden)

    Narzisi A

    2015-06-01

    Full Text Available Antonio Narzisi,1 Filippo Muratori,1,2 Massimo Buscema,3,4 Sara Calderoni,1 Enzo Grossi3,5 1Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 2Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 3Semeion Research Centre of Sciences of Communication, Rome, Italy; 4Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO, USA; 5Autism Research Unit, Villa Santa Maria Institute, Tavernerio, Italy Background: Treatment as usual (TAU for autism spectrum disorders (ASDs includes eclectic treatments usually available in the community and school inclusion with an individual support teacher. Artificial neural networks (ANNs have never been used to study the effects of treatment in ASDs. The Auto Contractive Map (Auto-CM is a kind of ANN able to discover trends and associations among variables creating a semantic connectivity map. The matrix of connections, visualized through a minimum spanning tree filter, takes into account nonlinear associations among variables and captures connection schemes among clusters. Our aim is to use Auto-CM to recognize variables to discriminate between responders versus no responders at TAU.Methods: A total of 56 preschoolers with ASDs were recruited at different sites in Italy. They were evaluated at T0 and after 6 months of treatment (T1. The children were referred to community providers for usual treatments. Results: At T1, the severity of autism measured through the Autism Diagnostic Observation Schedule decreased in 62% of involved children (Response, whereas it was the same or worse in 37% of the children (No Response. The application of the Semeion ANNs overcomes the 85% of global accuracy (Sine Net almost reaching 90%. Consequently, some of the tested algorithms were able to find a good correlation between some variables and TAU outcome. The semantic connectivity map obtained with the application of the Auto-CM system showed

  8. Preliminary evidence for an association between a dopamine D3 receptor gene variant and obsessive-compulsive personality disorder in patients with major depression.

    Science.gov (United States)

    Light, Katrina J; Joyce, Peter R; Luty, Suzanne E; Mulder, Roger T; Frampton, Christropher M A; Joyce, Laura R M; Miller, Allison L; Kennedy, Martin A

    2006-06-05

    We have previously reported that the Ser9Gly dopamine D3 receptor (DRD3) polymorphism was associated with increased rates of obsessive-compulsive personality disorder (OCPD) symptomology. We tested the replicability of this association within a further two independent groups of individuals with a history of depression, from a clinical sample (n = 149) and a family study (n = 213). The data from the replication samples and the original sample, within which the association was found, were compiled within a meta-analysis. Although the independent samples did not replicate the original finding, the meta-analysis elucidated significant evidence supporting the association. An individual with Gly/Gly genotype is 2.4 (P = 0.017) times more likely to be diagnosed with OCPD. Male gender was also found to be a significant predictor of OCPD diagnosis (OR = 2.82, P = 0.001). An exploration of an association of DRD3 with Axis I anxiety disorder diagnoses and Temperament and Character Inventory (TCI) traits, in particular persistence, revealed no support for an association. We conclude that DRD3 may contribute to the development of OCPD.

  9. Original article The structure of symptoms of posttraumatic stress disorder according to DSM-5 and assessed by PDS-5 – preliminary results

    Directory of Open Access Journals (Sweden)

    Bogdan Zawadzki

    2015-03-01

    Full Text Available Background The structure of posttraumatic stress disorder (PTSD symptoms has been studied and discussed since the introduction of PTSD as a diagnostic entity in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders III in 1980. Many studies supported a four-factor or a five-factor models, both inconsistent with DSM-IV. It is unclear whether current DSM-5 criteria appropriately reflect the empirical structure of PTSD symptoms. Participants and procedure In this study the structure of PTSD symptoms was examined by confirmatory factor analysis conducted on the data obtained from 388 individuals (150 males and 239 females aged 18-83 who experienced a traumatic event and completed the PDS-5 (Posttraumatic Diagnostic Scale-5, a self-report scale according to the DSM-5 criteria. Results Fitting of different models based on DSM-IV, DSM-5 and other the most common four- and five-factor conceptualizations of PTSD symptoms structure was examined. The data analyses demonstrated the best fit of the six-factor model based on the conceptualization of Elhai et al. (2011 with the additional factor of negative cognitions and mood. Conclusions The DSM-5 diagnostic criteria do not reflect the empirical PTSD symptom structure. The data suggest also that it is reasonable to separate the core PTSD symptoms from broad PTSD symptomatology.

  10. How and why affective and reactive virtual agents will bring new insights on social cognitive disorders in schizophrenia? An illustration with a virtual card game paradigm

    Directory of Open Access Journals (Sweden)

    Ali eOker

    2015-03-01

    Full Text Available In recent decades, many studies have shown that schizophrenia is associated with severe social cognitive impairments affecting key components, such as the recognition of emotions, theory of mind, attributional style and metacognition. Most studies investigated each construct separately, precluding analysis of the interactive and immersive nature of real-life situation. Specialized batteries of tests are under investigation to assess social cognition which is thought now as a link between neurocognitive disorders and impaired functioning. However, this link accounts for a limited part of the variance of real life functioning. To fill this gap, advances in virtual reality and affective computing have made it possible to carry out experimental investigations of naturalistic social cognition, in controlled conditions, with good reproducibility. This approach is illustrated with the description of a new paradigm based on an original virtual card game in which subjects interpret emotional displays from a female virtual agent, and decipher her helping intentions. Independent variables concerning emotional expression in terms of valence and intensity were manipulated. We show how several useful dependant variables, ranging from classic experimental psychology data to metacognition or subjective experiences records, may be extracted from a single experiment. Methodological issues about the immersion into a simulated intersubjective situation are considered. The example of this new flexible experimental setting with regards to the many constructs recognized in social neurosciences, constitutes a rationale for focusing on this potential intermediate link between standardized tests and real life functioning, and also for using it as an innovative media for cognitive remediation.

  11. How and why affective and reactive virtual agents will bring new insights on social cognitive disorders in schizophrenia? An illustration with a virtual card game paradigm.

    Science.gov (United States)

    Oker, Ali; Prigent, Elise; Courgeon, Matthieu; Eyharabide, Victoria; Urbach, Mathieu; Bazin, Nadine; Amorim, Michel-Ange; Passerieux, Christine; Martin, Jean-Claude; Brunet-Gouet, Eric

    2015-01-01

    In recent decades, many studies have shown that schizophrenia is associated with severe social cognitive impairments affecting key components, such as the recognition of emotions, theory of mind, attributional style, and metacognition. Most studies investigated each construct separately, precluding analysis of the interactive and immersive nature of real-life situation. Specialized batteries of tests are under investigation to assess social cognition, which is thought now as a link between neurocognitive disorders and impaired functioning. However, this link accounts for a limited part of the variance of real-life functioning. To fill this gap, advances in virtual reality and affective computing have made it possible to carry out experimental investigations of naturalistic social cognition, in controlled conditions, with good reproducibility. This approach is illustrated with the description of a new paradigm based on an original virtual card game in which subjects interpret emotional displays from a female virtual agent, and decipher her helping intentions. Independent variables concerning emotional expression in terms of valence and intensity were manipulated. We show how several useful dependant variables, ranging from classic experimental psychology data to metacognition or subjective experiences records, may be extracted from a single experiment. Methodological issues about the immersion into a simulated intersubjective situation are considered. The example of this new flexible experimental setting, with regards to the many constructs recognized in social neurosciences, constitutes a rationale for focusing on this potential intermediate link between standardized tests and real-life functioning, and also for using it as an innovative media for cognitive remediation.

  12. Meeting Disorders.

    Science.gov (United States)

    Yager, Joel; Katzman, Jeffrey W

    2017-12-01

    Although meetings are central to organizational work, considerable time devoted to meetings in Academic Health Centers appears to be unproductively spent. The primary purposes of this article are to delineate and describe Meeting Disorders, pathological processes resulting in these inefficient and ineffective scenarios, and Meeting Fatigue Disorder (MFD), a clinical syndrome. The paper also offers preliminary approaches to remedies. The authors integrate observations made during tens of thousands of hours in administrative meetings in academic medical settings with information in the literature regarding the nature, causes and potential interventions for dysfunctional groups and meetings. Meeting Disorders, resulting from distinct pathologies of leadership and organization, constitute prevalent subgroups of the bureaucrapathologies, pathological conditions caused by dysfunctional bureaucratic processes that generate excesses of wasted time, effort, and other resources. These disorders also generate frustration and demoralization among participants, contributing to professional burnout. Meeting Fatigue Disorder (MFD) is a subjective condition that develops in individuals who overdose on these experiences and may reflect one manifestation of burnout. Meeting disorders and Meeting Fatigue Disorder occur commonly in bureaucratic life. Resources and potential remedies are available to help ameliorate their more deleterious effects.

  13. Insight into cation disorder of Li{sub 2}Fe{sub 0.5}Mn{sub 0.5}SiO{sub 4}

    Energy Technology Data Exchange (ETDEWEB)

    Bini, Marcella [Dept. of Chemistry, University of Pavia, viale Taramelli 16, Pavia 27100 (Italy); Ferrari, Stefania, E-mail: stefania.ferrari@unipv.it [Dept. of Chemistry, University of Pavia, viale Taramelli 16, Pavia 27100 (Italy); Capsoni, Doretta; Spreafico, Clelia; Tealdi, Cristina; Mustarelli, Piercarlo [Dept. of Chemistry, University of Pavia, viale Taramelli 16, Pavia 27100 (Italy)

    2013-04-15

    Transition metal lithium orthosilicates are promising cathode materials for lithium-ion batteries. Here we report a combined experimental (in situ X-ray diffraction) and computational (static lattice and molecular dynamics) study of the thermal behavior of the Li{sub 2}Fe{sub 0.5}Mn{sub 0.5}SiO{sub 4} orthosilicate from room temperature to 950 °C. Our X-ray results showed that Pmnb polymorph is the most stable all over the explored temperature range. A significant cation disorder up to 80%, based on the anti-site defect, was found. The defect concentration depends on the synthesis route and temperature, and is completely reversible after the thermal treatments. Moreover, a careful analysis of the impurity phases allowed us to identify Li{sub 2}SiO{sub 3}, Fe{sub 3}O{sub 4} and Li{sub 3}Fe{sub 5}O{sub 8}, the last one never reported before. The minimization of defects by opportunely tuning the synthetic parameters would be of great importance in view of potential applications of these materials in lithium batteries. - Graphical abstract: A combined experimental in situ X-ray diffraction and computational study of the thermal behavior of the Li{sub 2}Fe{sub 0.5}Mn{sub 0.5}SiO{sub 4} is reported herein. The anti-site defect does justify the diffraction patterns changes with temperature. Highlights: ► Study of the thermal behavior of Li{sub 2}Fe{sub 0.5}Mn{sub 0.5}SiO{sub 4}. ► The anti-site defect does justify the diffraction patterns changes with temperature. ► The Pmnb polymorph is stable in the investigated temperaturerange.

  14. New insights in the interpretation of array-CGH: autism spectrum disorder and positive family history for intellectual disability predict the detection of pathogenic variants.

    Science.gov (United States)

    Cappuccio, Gerarda; Vitiello, Francesco; Casertano, Alberto; Fontana, Paolo; Genesio, Rita; Bruzzese, Dario; Ginocchio, Virginia Maria; Mormile, Angela; Nitsch, Lucio; Andria, Generoso; Melis, Daniela

    2016-04-12

    Array-CGH (aCGH) is presently used into routine clinical practice for diagnosis of patients with intellectual disability (ID), multiple congenital anomalies (MCA), and autism spectrum disorder (ASD). ACGH could detect small chromosomal imbalances, copy number variations (CNVs), and closely define their size and gene content. ACGH detects pathogenic imbalances in 14-20 % of patients with ID. The aims of this study were: to establish clinical clues potentially associated with pathogenic CNVs and to identify cytogenetic indicators to predict the pathogenicity of the variants of uncertain significance (VOUS) in a large cohort of paediatric patients. We enrolled 214 patients referred for either: ID, and/or ASD and/or MCA to genetic services at the Federico II University of Naples, Department of Translational Medicine. For each patient we collected clinical and imaging data. All the patients were tested with aCGH or as first-tier test or as part of a wider diagnostic work-up. Pathologic data were detected in 65 individuals (30 %) and 46 CNVs revealed a known syndrome. The pathological CNVs were usually deletions showing the highest gene-dosage content. The positive family history for ID/ASD/MCA and ASD were good indicators for detecting pathological chromosomal rearrangements. Other clinical features as eyes anomalies, hearing loss, neurological signs, cutaneous dyscromia and endocrinological problems seem to be potential predictors of pathological CNVs. Among patients carrying VOUS we analyzed genetic features including CNVs size, presence of deletion or duplication, genic density, multiple CNVs, to clinical features. Higher gene density was found in patients affected by ID. This result suggest that higher gene content has more chances to include pathogenic gene involved and causing ID in these patients. Our study suggest the use of aCGH as first-tier test in patients with neurdevelopmental phenotypes. The inferred results have been used for building a flow-chart to be

  15. Social Tools And Rules for Teens (The START Program): Program Description and Preliminary Outcomes of an Experiential Socialization Intervention for Adolescents with Autism Spectrum Disorder.

    Science.gov (United States)

    Vernon, Ty W; Miller, Amber R; Ko, Jordan A; Wu, Victoria L

    2016-05-01

    Experiential learning is an essential process in the development of core social competencies. Unfortunately, adolescents with autism spectrum disorders often do not possess the prerequisite skillset and motivation to sustain the level of social immersion needed to benefit from this learning process. These persisting social vulnerabilities can limit their long-term relational success and associated quality of life, creating a need for comprehensive social programming. This paper describes a multi-component socialization intervention that simultaneously targets motivational, conceptual, and skill deficits using a hybrid experiential/didactic treatment approach. Evidence of social competence improvements was noted in survey and live conversational measures, indicating that the START program may hold promise as a method for improving the social success of participating adolescents with ASD.

  16. Insights into the Pathology of the α3 Na(+)/K(+)-ATPase Ion Pump in Neurological Disorders; Lessons from Animal Models.

    Science.gov (United States)

    Holm, Thomas H; Lykke-Hartmann, Karin

    2016-01-01

    consequences of Atp1a3 modulation. The different mice show varying degrees of hyperactivity, gait problems, and learning disability as well as stress-induced seizures. With the advent of several Atp1a3-gene or chemically modified animal models that closely phenocopy many aspects of the human disorders, we will be able to reach a much better understanding of the etiology of RDP, AHC, and CAPOS syndrome.

  17. Executive control in schizophrenia: a preliminary study on the moderating role of COMT Val158Met for comorbid alcohol and substance use disorders.

    Science.gov (United States)

    Carrà, Giuseppe; Nicolini, Gabriella; Crocamo, Cristina; Lax, Annamaria; Amidani, Francesca; Bartoli, Francesco; Castellano, Filippo; Chiorazzi, Alessia; Gamba, Giulia; Papagno, Costanza; Clerici, Massimo

    2017-07-01

    A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val158Met) appears to influence cognition in people with alcohol/substance use disorders (AUD/SUD) and in those with psychosis. To explore the potential moderating effect of these factors, a cross-sectional study was conducted, randomly recruiting subjects with DSM-IV diagnosis of schizophrenia. AUD/SUD was rigorously assessed, as well as COMT Val158Met polymorphism. Executive control functioning was measured using the Intra-Extra Dimensional Set Shift (IED). The effect of a possible interaction between comorbid AUD/SUD and COMT Val158Met polymorphism on IED scores was explored. Subjects with schizophrenia, comorbid AUD/SUD, and MetMet carriers for SNP rs4680 of the COMT gene showed worse performance on IED completed stages scores, as compared with individuals with ValVal genotype. However, among subjects without AUD/SUD, those with the MetMet variant performed better than people carrying ValVal genotype. This study is the first to date examining the impact of COMT on cognition in a highly representative sample of people with schizophrenia and comorbid AUD/SUD. Differential moderating effects of COMT Val/Met genotype variations may similarly influence executive functions in people with schizophrenia and comorbid AUD/SUD.

  18. Intellectual Functioning in In-Patients with Substance Use Disorders: Preliminary Results from a Clinical Mediation Study of Factors Contributing to IQ Variance.

    Science.gov (United States)

    Braatveit, Kirsten J; Torsheim, Torbjørn; Hove, Oddbjørn

    2018-01-01

    To investigate the direct effect of different childhood difficulties on adult intelligence coefficient (IQ) and their possible indirect effect through the mediating pathways of education and severity substance use. Ninety in-patients aged 19-64. The participants had abstained from substance use for at least 6 weeks and had different substance use profiles. Substance use disorder (SUD) and psychiatric illnesses were diagnosed according to the International Classification of Diseases 10th edition criteria. IQ was measured with the Wechsler Adult Intelligence Scale, 4th edition. Childhood difficulties, severity of substance use and level of education were assessed through a self-report questionnaire. Mean full scale IQ for the studied population was 87.3. Learning and attention deficit/hyperactivity difficulties in childhood were directly related to adult IQ. Education had a mediating effect between childhood learning difficulties/conduct problems and the verbal comprehension index. There was no significant difference in IQ due to the specific substance used or severity of substance use. IQ variance in in-treatment individuals with SUD was related to childhood functioning alone or through the mediator of education. Substance-related factors did not contribute to IQ variance. The results fit a normal theory of IQ development with commonly known risk factors and no disturbing effect of substance use. © 2018 S. Karger AG, Basel.

  19. Dual-task study of cognitive and postural interference: a preliminary investigation of the automatization deficit hypothesis of developmental co-ordination disorder.

    Science.gov (United States)

    Tsai, C-L; Pan, C-Y; Cherng, R-J; Wu, S-K

    2009-07-01

    The purpose of this study was to investigate whether children with developmental co-ordination disorder and balance problem (DCD-BP) had greater problems than controls in performing a primary balance task while concurrently completing different cognitive tasks varying in oral or listening cognitive complexity, as well as to investigate the automatization deficit hypothesis of DCD-BP. Children with DCD-BP (n= 39), along with age-matched control counterparts (n= 39), were placed on automatic processing situation under dual-task conditions. All children were required to perform a primary task, five dual-task paradigms (oral counting task, auditory-verbal reaction task, auditory-choice reaction task, auditory-memory task and articulation alone) and an eyes-closed balancing task. In the primary task condition, the differences were not statistically significant (P= 0.393) between children with and without DCD-BP. However, children with DCD-BP were significantly more impaired on three of five dual-task conditions (oral counting task: P= 0.003; auditory-verbal reaction task: P= 0.011; auditory-memory task: P= 0.041) compared with the single-task situation, with the exception of the auditory-choice reaction task (P= 0.471) and articulation alone (P= 0.067). These results suggest that children with DCD-BP were more cognitively dependant and may have an automatization deficit.

  20. A multi-factor model of panic disorder: results of a preliminary study integrating the role of perfectionism, stress, physiological anxiety and anxiety sensitivity

    Directory of Open Access Journals (Sweden)

    Cristina M. Wood

    2015-05-01

    Full Text Available Background: Panic disorder (PD is a highly prevalent and disabling mental health problem associated with different factors including perfectionism, stress, physiological anxiety, and anxiety sensitivity regarding physical concerns; however, no studies have analyzed the joint relationship between these factors and PD in a multi-factor model using structural equation modeling. Method: A cross-sectional study was carried out to collect data on these factors and self-reported DSM-IV past-year PD symptoms in a large sample of the general population (N=936. Results: Perceived stress had a significant effect in increasing physiological anxiety, which in turn had an important association with physical concerns. Perfectionism and perceived stress had an indirect relation with past year PD via the mediator role of physiological anxiety and physical concerns. Physical concerns, on one hand, seemed to mediate the impact between perfectionism and PD and, on the other, partially mediated the role between physiological anxiety and PD. Conclusions: Although there is considerable evidence on the association between each of these factors and PD, this model can be considered a broader and productive framework of research on the nature and treatment of PD.

  1. Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol.

    Science.gov (United States)

    Harned, Melanie S; Korslund, Kathryn E; Foa, Edna B; Linehan, Marsha M

    2012-06-01

    This study focused on the development and pilot testing of a protocol based on Prolonged Exposure (PE) that can be added to Dialectical Behavior Therapy (DBT) to treat PTSD in suicidal and self-injuring individuals with borderline personality disorder (BPD). Women with BPD, PTSD, and recent and/or imminent serious intentional self-injury (n = 13) received one year of DBT with the DBT PE Protocol, plus three months of follow-up assessment. The treatment was associated with significant reductions in PTSD, with the majority of patients no longer meeting criteria for PTSD at post-treatment (71.4% of DBT PE Protocol completers, 60.0% of the intent-to-treat sample). A minority of patients (27.3%) engaged in intentional self-injury during the study. Improvements were also found for suicidal ideation, dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and social adjustment. There was no evidence that the DBT PE Protocol led to exacerbations of intentional self-injury urges or behaviors, PTSD, treatment dropout, or crisis service use. Overall, the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapists, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. French 900 MWe PWR PSA preliminary results

    International Nuclear Information System (INIS)

    Lanore, J.M.; Brisbois, J.

    1988-10-01

    A PSA is performed by the Safety Assessment Department of CEA for a 900 MWe standardized plant. The paper presents the objectives, the scope of the study and the relative preliminary results. Some general insights are drawn, especially the benefit related to the implementation of emergency procedures

  3. The relationship between insight and psychosis in state patients with ...

    African Journals Online (AJOL)

    Objective. State patients committed under the Mental Health Act must have insight into their illness and the crime they committed before they can be discharged. Patients with schizophrenia are described as having poor insight into the nature and severity of their disorder. Various factors influence insight, and in some studies ...

  4. Non-invasive Vagal Nerve Stimulation Effects on Hyperarousal and Autonomic State in Patients with Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury: Preliminary Evidence

    Directory of Open Access Journals (Sweden)

    Damon G. Lamb

    2017-07-01

    Full Text Available Posttraumatic stress disorder (PTSD is a reaction to trauma that results in a chronic perception of threat, precipitating mobilization of the autonomic nervous system, and may be reflected by chronic disinhibition of limbic structures. A common injury preceding PTSD in veterans is mild traumatic brain injury (mTBI. This may be due to the vulnerability of white matter in these networks and such damage may affect treatment response. We evaluated transcutaneous vagal nerve stimulation (tVNS, a non-invasive, low-risk approach that may alter the functions of the limbo-cortical and peripheral networks underlying the hyperarousal component of PTSD and thus improve patient health and well-being. In this single visit pilot study evaluating the impact of tVNS in 22 combat veterans, we used a between-subjects design in people with either PTSD with preceding mTBI or healthy controls. Participants were randomized into stimulation or sham groups and completed a posturally modulated autonomic assessment and emotionally modulated startle paradigm. The primary measures used were respiratory sinus arrhythmia (high-frequency heart rate variability during a tilt-table procedure derived from an electrocardiogram, and skin conductance changes in response to acoustic startle while viewing emotional images (International Affective Picture System. The stimulation was well tolerated and resulted in improvements in vagal tone and moderation of autonomic response to startle, consistent with modulation of autonomic state and response to stress in this population. Our results suggest that tVNS affects systems underlying emotional dysregulation in this population and, therefore, should be further evaluated and developed as a potential treatment tool for these patients.

  5. Instrument to screen cases of pervasive developmental disorder: a preliminary indication of validity Instrumento para rastreamento dos casos de transtorno invasivo do desenvolvimento: estudo preliminar de validação

    Directory of Open Access Journals (Sweden)

    Fábio Pinato Sato

    2009-03-01

    Full Text Available OBJECTIVE: To translate into Portuguese, back-translate, culturally adapt and validate a screening instrument for pervasive developmental disorder, the Autism Screening Questionnaire, for use in Brazil. METHOD: A sample of 120 patients was selected based on three groups of 40: patients with a clinical diagnosis of pervasive developmental disorder, Down syndrome, or other psychiatric disorders. The self-administered questionnaire was applied to the patients' legal guardians. Psychometric measures of the final version of the translated questionnaire were tested. RESULTS: The score of 15 had sensitivity of 92.5% and specificity of 95.5% as a cut-off point for the diagnosis of pervasive developmental disorder. Internal validity for a total of 40 questions was 0.895 for alpha and 0.896 for KR-20, ranging from 0.6 to 0.8 for both coefficients. Test and retest reliability values showed strong agreement for most questions. CONCLUSIONS: The final version of this instrument, translated into Portuguese and adapted to the Brazilian culture, had satisfactory measurement properties, suggesting preliminary validation proprieties. It was an easy-to-apply, useful tool for the diagnostic screening of individuals with pervasive developmental disorder.OBJETIVO: Tradução, retro-versão, adaptação cultural e validação do Autism Screening Questionnaire para a língua portuguesa e para o seu uso no Brasil. MÉTODO: Foi selecionada uma amostra inicial de 120 pacientes, encaminhados de duas clínicas privadas e uma pública, divida em três grupos de 40 pacientes distintos: pacientes com diagnóstico clínico de transtornos globais do desenvolvimento ou transtornos invasivos do desenvolvimento; de síndrome de Down e de outros transtornos psiquiátricos. O questionário foi aplicado aos responsáveis legais dos pacientes seguindo os padrões de um questionário auto-aplicável. As medidas psicométricas do questionário traduzido, na sua versão final, foram

  6. Betaxolol in anxiety disorders.

    Science.gov (United States)

    Swartz, C M

    1998-03-01

    Betaxolol, a long-acting beta-adrenergic blocker that enters the central nervous system, was examined for therapeutic effects on the persistent anxiety of anxiety disorders. Prior studies of beta-blockers examined only agents that were short-acting or did not enter the brain. Betaxolol was administered to 31 patients in open trials. Of 13 outpatients, 11 had generalized anxiety disorder (GAD) and 2 had adjustment disorder with anxiety. Five with GAD had concurrent panic disorder. Of 18 inpatients, 16 had GAD and 2 had adjustment disorder with anxiety. Betaxolol doses were increased until the patient responded or declined further dosage. Severity was rated on a 4-point global scale. Before betaxolol, all were moderately or severely ill. In all patients with panic disorder panic attacks stopped within 2 days (pAnxiety decreased to no more than marginally ill in 85% of outpatients (panxiety and obsessive-compulsive personality disorder. Preliminary observations in posttraumatic stress disorder are similar.

  7. Course of insight in manic episode

    Directory of Open Access Journals (Sweden)

    A Kumar

    2013-01-01

    Full Text Available Background: Insight is an important factor associated with non compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences with increasing severity in manic episode. Aim: Main aim of study was to see the baseline and longitudinal relationship between dimensions of insight with improvement in psychopathology. Setting and Design: Forty four patients diagnosed with mania, were selected from an inpatient setting at Institute of Mental Health and Hospital, Agra with mean age of 31.07(±9.00 years. They were assessed at base line and were followed up weekly or psychopathology and insight. Materials and Methods: The Young′s mania rating scale for psychopathology and insight was assessed on three dimensions of SUMD. Results: Twenty five patients eventually completed the study. There was a positive correlation with global insight and with psychopathology consistent in longitudinal follow-up (P<0.05, but not correlating for awareness for achieved effect of medication and social consequences. Linear regression showed a positive relationship at the first and second week of assessment of SUMD and YMRS scores (P=0.001; 0.019. Conclusion: Improvement in insight is graded in a manic episode as compared to psychopathology. There is slower improvement in awareness of social consequences of mental disorder. It means that improvement in psychopathology may not necessarily indicate remission and need further supervision to improve insight and hence monitoring.

  8. Preliminary examination of metabolic syndrome response to motivational interviewing for weight loss as compared to an attentional control and usual care in primary care for individuals with and without binge-eating disorder.

    Science.gov (United States)

    Barnes, Rachel D; Barber, Jessica A

    2017-08-01

    Motivational interviewing (MI) treatment for weight loss is being studied in primary care. The effect of such interventions on metabolic syndrome or binge eating disorder (BED), both highly related to excess weight, has not been examined in primary care. This study conducted secondary analyses from a randomized controlled trial to test the impact of MI for weight loss in primary care on metabolic syndrome. 74 adult participants with overweight/obesity recruited through primary care were randomized to 12weeks of either MI, an attentional control, or usual care. Participants completed measurements for metabolic syndrome at pre- and post-treatment. There were no statistically significant differences in metabolic syndrome rates at pre-, X 2 (2)=0.16, p=0.921, or post-, X 2 (2)=0.852, p=0.653 treatment. The rates in metabolic syndrome, however, decreased for MI (10.2%) and attentional control (13.8%) participants, but not for usual care. At baseline, metabolic syndrome rates did not differ significantly between participants with BED or without BED across treatments. At post-treatment, participants with BED were significantly more likely to meet criteria for metabolic syndrome than participants without BED, X 2 (1)=5.145, p=0.023, phi=0.273. Across treatments, metabolic syndrome remitted for almost a quarter of participants without BED (23.1%) but for 0% of those with BED. These preliminary results are based on a small sample and should be interpreted with caution, but they are the first to suggest that relatively low intensity MI weight loss interventions in primary care may decrease metabolic syndrome rates but not for individuals with BED. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Clinical correlates of loss of insight in bipolar depression

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    Full Text Available Abstract Introduction Affective state may influence insight, especially regarding mania. Nevertheless, studies have so far suggested that depression seems not to significantly impair insight. To the best of our knowledge, this study pioneers the evaluation of how insight variations in bipolar depression correlate with clinical variables. Method A group of 165 bipolar patients, 52 of whom had depressive episodes according to DSM-5 criteria, were followed during a year. All patients underwent clinical assessment, and insight was evaluated through the Insight Scale for Affective Disorders (ISAD. Repeated-measures ANOVA was calculated comparing scores on the four ISAD factors (insight into symptoms, the condition itself, self-esteem and social relationships in order to investigate differences in insight according to different objects. Correlational analysis explored which clinical symptoms were linked to reduced insight. Results Worse total insight correlated with suicide attempt/ideation and fewer subsyndromal manic symptoms such as mood elevation, increased energy and sexual interest. Worse self-esteem insight was associated with not only suicide ideation/attempt but also with activity reduction and psychomotor retardation. Worse symptom insight also correlated with psychomotor retardation. Better insight into having an affective disorder was associated with more intense hypochondria symptoms. Finally, worse insight into having an illness was associated with psychotic episodes. Conclusion Our study found that symptoms other than psychosis – suicide ideation, psychomotor retardation and reduction of activity and work – correlate with insight impairment in bipolar depression.

  10. Insights into the Molecular Mechanisms of Alzheimer’s and Parkinson’s Diseases with Molecular Simulations: Understanding the Roles of Artificial and Pathological Missense Mutations in Intrinsically Disordered Proteins Related to Pathology

    Directory of Open Access Journals (Sweden)

    Orkid Coskuner-Weber

    2018-01-01

    Full Text Available Amyloid-β and α-synuclein are intrinsically disordered proteins (IDPs, which are at the center of Alzheimer’s and Parkinson’s disease pathologies, respectively. These IDPs are extremely flexible and do not adopt stable structures. Furthermore, both amyloid-β and α-synuclein can form toxic oligomers, amyloid fibrils and other type of aggregates in Alzheimer’s and Parkinson’s diseases. Experimentalists face challenges in investigating the structures and thermodynamic properties of these IDPs in their monomeric and oligomeric forms due to the rapid conformational changes, fast aggregation processes and strong solvent effects. Classical molecular dynamics simulations complement experiments and provide structural information at the atomic level with dynamics without facing the same experimental limitations. Artificial missense mutations are employed experimentally and computationally for providing insights into the structure-function relationships of amyloid-β and α-synuclein in relation to the pathologies of Alzheimer’s and Parkinson’s diseases. Furthermore, there are several natural genetic variations that play a role in the pathogenesis of familial cases of Alzheimer’s and Parkinson’s diseases, which are related to specific genetic defects inherited in dominant or recessive patterns. The present review summarizes the current understanding of monomeric and oligomeric forms of amyloid-β and α-synuclein, as well as the impacts of artificial and pathological missense mutations on the structural ensembles of these IDPs using molecular dynamics simulations. We also emphasize the recent investigations on residual secondary structure formation in dynamic conformational ensembles of amyloid-β and α-synuclein, such as β-structure linked to the oligomerization and fibrillation mechanisms related to the pathologies of Alzheimer’s and Parkinson’s diseases. This information represents an important foundation for the successful and

  11. New insights into how genetic disorders arise

    International Nuclear Information System (INIS)

    Unrau, P.

    1992-01-01

    One questionable assumption in genetic risk assessment is that all members of the population are equally at risk to the causative agent. The invalidity of this assumption can be demonstrated by considering data on the range of sensitivity to ionizing radiation of lymphoblastoid cell lines derived from various normal members of the population or from various disease groups associated with extreme radiosensitivity. Some 'normal' cell lines are as sensitive as those from the disease groups. A certain proportion of the normal population may be heterozygotic for many of the genes that lead to radiosensitivity. There are many cancer-facilitating genes in the population. These are made homozygotic by somatic mechanisms, or by breeding patterns. Mechanisms at the DNA level that lead to homozygosity change the risk within tissues and thus individuals. We need to measure heterozygosity, breeding effects, and molecular mechanisms to determine the causes of genetic and somatic risk. (L.L.)

  12. Tic disorders.

    Science.gov (United States)

    Martino, Davide; Mink, Jonathan W

    2013-10-01

    Primary tic disorders are complex, multifactorial disorders in which tics are accompanied by other sensory features and an array of comorbid behavioral disorders. Secondary tics are proportionally much less frequent, but their etiology is diverse. This review aims to guide clinicians in the recognition of the phenomenology, pathophysiology, and treatment of these disorders. Advances include greater phenomenologic insights, particularly of nonmotor (sensory) features; increased knowledge of disease mechanisms, particularly coming from neuropsychological, functional imaging, pathologic, and animal model studies; growing evidence on the efficacy of alpha-2 agonists and the newer generation of dopamine-modulating agents; and recent strides in the evaluation of cognitive-behavioral therapy and deep brain stimulation surgery. The correct diagnostic approach to tic disorders requires accurate historical gathering, a thorough neurologic examination, and detailed definition of the patient's psychopathologic profile. Treatment should always begin with individualized psychoeducational strategies. Although pharmacologic treatments remain beneficial for most patients, cognitive-behavioral treatments have thus far shown promising efficacy. Deep brain stimulation surgery should still be limited to adult patients refractory to pharmacotherapy and cognitive-behavioral therapy.

  13. The association of lifetime insight and cognition in psychosis.

    Science.gov (United States)

    Sánchez-Torres, Ana M; Zarzuela, Amalia; Peralta, Victor; Cuesta, Manuel J

    2015-03-01

    Poor insight has been related to poor course in psychosis. However, the role of cognition in insight remains unclear. The aim of this study was to examine the influence of cognition and lifetime psychopathological dimensions on insight in psychosis. We followed up 42 patients with psychotic disorders over 10years. Lifetime psychopathological dimensions and cognitive performance were assessed. Patients were divided into two groups by lifetime patterns of insight and compared with 42 healthy volunteers. Lower IQ and poorer social cognition were associated with higher risks of poorer lifetime insight of feeling ill and global insight respectively. Lifetime negative symptoms were associated with a higher risk of poorer lifetime insight into symptoms. Lifetime lack of insight is independent of cognitive impairment in specific domains, except for social cognition. Higher IQ may contribute to better lifetime awareness of illness, while better ability to manage emotions is involved in lifetime global insight. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Chronic complex dissociative disorders and borderline personality disorder: disorders of emotion dysregulation?

    Science.gov (United States)

    Brand, Bethany L; Lanius, Ruth A

    2014-01-01

    Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research.

  15. Preliminary Monthly Climatological Summaries

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

  16. the relationship between insight and psychosis in state patients with ...

    African Journals Online (AJOL)

    understanding of problems and personality traits as applied to the self, but also an ... between insight scores and the severity of the mental disorder were measured. ..... namely psychopathology (for instance paranoia, hostility, perplexity and ...

  17. Neurocomputational models of brain disorders

    NARCIS (Netherlands)

    Cutsuridis, Vassilis; Heida, Tjitske; Duch, Wlodek; Doya, Kenji

    2011-01-01

    Recent decades have witnessed dramatic accumulation of knowledge about the genetic, molecular, pharmacological, neurophysiological, anatomical, imaging and psychological characteristics of brain disorders. Despite these advances, however, experimental brain science has offered very little insight

  18. Proofs that Develop Insight

    Science.gov (United States)

    Weber, Keith

    2010-01-01

    Many mathematics educators have noted that mathematicians do not only read proofs to gain conviction but also to obtain insight. The goal of this article is to discuss what this insight is from mathematicians' perspective. Based on interviews with nine research-active mathematicians, two sources of insight are discussed. The first is reading a…

  19. Preliminary experimental insights into differential heat impact among lithic artifacts

    OpenAIRE

    Guillermo Bustos-Pérez; Javier Baena Preysler

    2016-01-01

    The presence of thermally altered and broken flint artifacts is common at archaeological sites. Most studies focus their attention on the effects of heat treatment on flint to improve knapping qualities, disregarding the effects of fire over flint under uncontrolled conditions. This paper aims to show how under uncontrolled heating processes flint artifacts develop different heat alterations (such as levels of breakage, presence of scales, etc.) as a result of vertical distribution, volume or...

  20. Tacit Knowledge for Military Leadership: Seeking Insight into the Acquisition and Use of Practical Knowledge

    National Research Council Canada - National Science Library

    Hedlund, Jennifer

    2000-01-01

    The goal of the project was to provide preliminary insight into the process of tacit knowledge acquisition and to support the development of tools to assess the use of various knowledge-acquisition...

  1. Anxiety Disorders

    Science.gov (United States)

    ... Registry Residents & Medical Students Residents Medical Students Patients & Families Mental Health Disorders/Substance Use Find a Psychiatrist Addiction and Substance Use Disorders ADHD Anxiety Disorders Autism Spectrum Disorder Bipolar Disorders Depression Eating Disorders Obsessive-Compulsive ...

  2. Mental Disorders

    Science.gov (United States)

    Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play ...

  3. Functional magnetic resonance imaging study of external source memory and its relation to cognitive insight in non-clinical subjects.

    Science.gov (United States)

    Buchy, Lisa; Hawco, Colin; Bodnar, Michael; Izadi, Sarah; Dell'Elce, Jennifer; Messina, Katrina; Lepage, Martin

    2014-09-01

    Previous research has linked cognitive insight (a measure of self-reflectiveness and self-certainty) in psychosis with neurocognitive and neuroanatomical disturbances in the fronto-hippocampal neural network. The authors' goal was to use functional magnetic resonance imaging (fMRI) to investigate the neural correlates of cognitive insight during an external source memory paradigm in non-clinical subjects. At encoding, 24 non-clinical subjects travelled through a virtual city where they came across 20 separate people, each paired with a unique object in a distinct location. fMRI data were then acquired while participants viewed images of the city, and completed source recognition memory judgments of where and with whom objects were seen, which is known to involve prefrontal cortex. Cognitive insight was assessed with the Beck Cognitive Insight Scale. External source memory was associated with neural activity in a widespread network consisting of frontal cortex, including ventrolateral prefrontal cortex (VLPFC), temporal and occipital cortices. Activation in VLPFC correlated with higher self-reflectiveness and activation in midbrain correlated with lower self-certainty during source memory attributions. Neither self-reflectiveness nor self-certainty significantly correlated with source memory accuracy. By means of virtual reality and in the context of an external source memory paradigm, the study identified a preliminary functional neural basis for cognitive insight in the VLPFC in healthy people that accords with our fronto-hippocampal theoretical model as well as recent neuroimaging data in people with psychosis. The results may facilitate the understanding of the role of neural mechanisms in psychotic disorders associated with cognitive insight distortions. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  4. Schizoaffective disorder

    Science.gov (United States)

    ... or do not improve with treatment Thoughts of suicide or of harming others Alternative Names Mood disorder - schizoaffective disorder; Psychosis - schizoaffective disorder Images Schizoaffective disorder ...

  5. Key players in neurodegenerative disorders in focus-New insights into the proteomic profile of Alzheimer's disease, schizophrenia, ALS, and multiple sclerosis-24th HUPO BPP Workshop: September 29, 2015, Vancouver, Canada.

    Science.gov (United States)

    Schrötter, Andreas; Park, Young Mok; Marcus, Katrin; Martins-de-Souza, Daniel; Nilsson, Peter; Magraoui, Fouzi El; Meyer, Helmut E; Grinberg, Lea T

    2016-04-01

    The HUPO Brain Proteome Project (HUPO BPP) held its 24th workshop in Vancouver, Canada, September 29, 2015. The focus of the autumn workshop was on new insights into the proteomic profile of Alzheimer's disease, schizophrenia, ALS and multiple sclerosis. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Body Dysmorphic Disorder: Neurobiological Features and an Updated Model

    Science.gov (United States)

    Li, Wei; Arienzo, Donatello; Feusner, Jamie D.

    2013-01-01

    Body Dysmorphic Disorder (BDD) affects approximately 2% of the population and involves misperceived defects of appearance along with obsessive preoccupation and compulsive behaviors. There is evidence of neurobiological abnormalities associated with symptoms in BDD, although research to date is still limited. This review covers the latest neuropsychological, genetic, neurochemical, psychophysical, and neuroimaging studies and synthesizes these findings into an updated (yet still preliminary) neurobiological model of the pathophysiology of BDD. We propose a model in which visual perceptual abnormalities, along with frontostriatal and limbic system dysfunction, may combine to contribute to the symptoms of impaired insight and obsessive thoughts and compulsive behaviors expressed in BDD. Further research is necessary to gain a greater understanding of the etiological formation of BDD symptoms and their evolution over time. PMID:25419211

  7. Insight and suicidality in psychosis: A cross-sectional study.

    Science.gov (United States)

    Massons, Carmen; Lopez-Morinigo, Javier-David; Pousa, Esther; Ruiz, Ada; Ochoa, Susana; Usall, Judith; Nieto, Lourdes; Cobo, Jesus; David, Anthony S; Dutta, Rina

    2017-06-01

    We aimed to test whether specific insight dimensions are associated with suicidality in patients with psychotic disorders. 143 patients with schizophrenia spectrum disorders were recruited. Suicidality was assessed by item 8 of the Calgary Depression Scale for Schizophrenia (CDSS). Insight was measured by the Scale of Unawareness of Mental Disorder (SUMD) and the Markova and Berrios Insight Scale. Bivariate analyses and multivariable logistic regression models were conducted. Those subjects aware of having a mental illness and its social consequences had higher scores on suicidality than those with poor insight. Awareness of the need for treatment was not linked with suicidality. The Markova and Berrios Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality. Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality. Copyright © 2017. Published by Elsevier B.V.

  8. PRA insights applicable to the design of the Broad Applications Test Reactor

    International Nuclear Information System (INIS)

    Khericha, S.T.; Reilly, H.J.

    1993-01-01

    Design insights applicable to the design of a new Broad Applications Test Reactor (BATR), being studied at Idaho National Engineering Laboratory, are summarized. Sources of design insights include past probabilistic risk assessments and related studies for department of Energy-owned Class A reactors and for commercial reactors. The report includes a preliminary risk allocation scheme for the BATR

  9. Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

    Science.gov (United States)

    Joseph, Boban; Narayanaswamy, Janardhanan C.; Venkatasubramanian, Ganesan

    2015-01-01

    Impairment of insight is considered as the hallmark of schizophrenia. Substantial proportion of patients with schizophrenia has either poor or absent insight. Insight is a multidimensional and dynamic construct which appears to have intricate links with other symptom dimensions of the psychotic illness. A better appreciation of the association that insight shares with other symptom clusters in psychosis could help us in gaining knowledge about aetiology, prognosis and treatment-related facets of the disorder. This is likely to have critical implications in the understanding and therapeutics of schizophrenia. PMID:25722504

  10. The intrinsically disordered structural platform of the plant defence hub protein RPM1-interacting protein 4 provides insights into its mode of action in the host-pathogen interface and evolution of the nitrate-induced domain protein family.

    Science.gov (United States)

    Sun, Xiaolin; Greenwood, David R; Templeton, Matthew D; Libich, David S; McGhie, Tony K; Xue, Bin; Yoon, Minsoo; Cui, Wei; Kirk, Christopher A; Jones, William T; Uversky, Vladimir N; Rikkerink, Erik H A

    2014-09-01

    Arabidopsis thaliana (At) RPM1-interacting protein 4 (RIN4), targeted by many defence-suppressing bacterial type III effectors and monitored by several resistance proteins, regulates plant immune responses to pathogen-associated molecular patterns and type III effectors. Little is known about the overall protein structure of AtRIN4, especially in its unbound form, and the relevance of structure to its diverse biological functions. AtRIN4 contains two nitrate-induced (NOI) domains and is a member of the NOI family. Using experimental and bioinformatic approaches, we demonstrate that the unbound AtRIN4 is intrinsically disordered under physiological conditions. The intrinsically disordered polypeptide chain of AtRIN4 is interspersed with molecular recognition features (MoRFs) and anchor-identified long-binding regions, potentially allowing it to undergo disorder-to-order transitions upon binding to partner(s). A poly-l-proline II structure, often responsible for protein recognition, is also identified in AtRIN4. By performing bioinformatics analyses on RIN4 homologues from different plant species and the NOI proteins from Arabidopsis, we infer the conservation of intrinsic disorder, MoRFs and long-binding regions of AtRIN4 in other plant species and the NOI family. Intrinsic disorder and MoRFs could provide RIN4 proteins with the binding promiscuity and plasticity required to act as hubs in a pivotal position within plant defence signalling cascades. © 2014 FEBS.

  11. In Search of Insight.

    Science.gov (United States)

    Kaplan, Craig A.; Simon, Herbert A.

    1990-01-01

    Attaining the insight needed to solve the Mutilated Checkerboard problem, which requires discovery of an effective problem representation (EPR), is described. Performance on insight problems can be predicted from the availability of generators and constraints in the search for an EPR. Data for 23 undergraduates were analyzed. (TJH)

  12. Neurobiological Basis of Insight in Schizophrenia: A Systematic Review.

    Science.gov (United States)

    Xavier, Rose Mary; Vorderstrasse, Allison

    2016-01-01

    Insight in schizophrenia is defined as awareness into illness, symptoms, and need for treatment and has long been associated with cognition, other psychopathological symptoms, and several adverse clinical and functional outcomes. However, the biological basis of insight is not clearly understood. The aim of this systematic review was to critically evaluate and summarize advances in the study of the biological basis of insight in schizophrenia and to identify gaps in this knowledge. A literature search of PubMed, CINAHL, PsycINFO, and EMBASE databases was conducted using search terms to identify articles relevant to the biology of insight in schizophrenia published in the last 6 years. Articles that focused on etiology of insight in schizophrenia and those that examined the neurobiology of insight in schizophrenia or psychoses were chosen for analysis. Articles on insight in conditions other than schizophrenia or psychoses and which did not investigate the neurobiological underpinnings of insight were excluded from the review. Twenty-six articles met the inclusion criteria for this review. Of the 26 articles, 3 focused on cellular abnormalities and 23 were neuroimaging studies. Preliminary data identify the prefrontal cortex, cingulate cortex, and regions of the temporal and parietal lobe (precuneus, inferior parietal lobule) and hippocampus as the neural correlates of insight. A growing body of literature attests to the neurobiological basis of insight in schizophrenia. Current evidence supports the neurobiological basis of insight in schizophrenia and identifies specific neural correlates for insight types and its dimensions. Further studies that examine the precise biological mechanisms of insight are needed to apply this knowledge to effective clinical intervention development.

  13. Stigma as a predictor of insight in schizophrenia.

    Science.gov (United States)

    Pruß, Linda; Wiedl, Karl Heinz; Waldorf, Manuel

    2012-07-30

    Insight in schizophrenia can be seen as a multifactorial phenomenon. Although multifactorial pathways have also been suggested for insight formation, motivational explanations have rarely been tested. The present study explores stigma as one possible determinant of a motivated lack of insight in integrated models of insight formation. It examines the contribution of socio-demographic and clinical variables, neurocognitive functions, symptoms, and stigma to the prediction of insight into illness. Patients diagnosed with schizophrenia spectrum disorders (N=111) participated in a comprehensive battery of instruments to measure insight dimensions, stigma, neurocognitive functions, symptoms, socio-demographic and clinical variables. Blockwise multiple regression analysis indicates significant association of variability in insight dimensions with gender (7%) and stigma (i. e., stereotype agreement: 5%). Our findings demonstrate an incremental validity of stigma, which indicates a motivational pathway of insight formation. This study enables better understanding of the multifactorial nature of insight, which should be considered in therapeutic interventions to improve insight. The roles of gender and neurocognitive functions in insight formation are also discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Dimensions of insight in schizophrenia: Exploratory factor analysis of items from multiple self- and interviewer-rated measures of insight.

    Science.gov (United States)

    Konsztowicz, Susanna; Schmitz, Norbert; Lepage, Martin

    2018-03-10

    Insight in schizophrenia is regarded as a multidimensional construct that comprises aspects such as awareness of the disorder and recognition of the need for treatment. The proposed number of underlying dimensions of insight is variable in the literature. In an effort to identify a range of existing dimensions of insight, we conducted a factor analysis on combined items from multiple measures of insight. We recruited 165 participants with enduring schizophrenia (treated for >3years). Exploratory factor analysis was conducted on itemized scores from two interviewer-rated measures of insight: the Schedule for the Assessment of Insight-Expanded and the abbreviated Scale to assess Unawareness of Mental Disorder; and two self-report measures: the Birchwood Insight Scale and the Beck Cognitive Insight Scale. A five-factor solution was selected as the best-fitting model, with the following dimensions of insight: 1) awareness of illness and the need for treatment; 2) awareness and attribution of symptoms and consequences; 3) self-certainty; 4) self-reflectiveness for objectivity and fallibility; and 5) self-reflectiveness for errors in reasoning and openness to feedback. Insight in schizophrenia is a multidimensional construct comprised of distinct clinical and cognitive domains of awareness. Multiple measures of insight, both clinician- and self-rated, are needed to capture all of the existing dimensions of insight. Future exploration of associations between the various dimensions and their potential determinants will facilitate the development of clinically useful models of insight and effective interventions to improve outcome. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. The neural exploitation hypothesis and its implications for an embodied approach to language and cognition: Insights from the study of action verbs processing and motor disorders in Parkinson's disease.

    Science.gov (United States)

    Gallese, Vittorio; Cuccio, Valentina

    2018-03-01

    As it is widely known, Parkinson's disease is clinically characterized by motor disorders such as the loss of voluntary movement control, including resting tremor, postural instability, and bradykinesia (Bocanegra et al., 2015; Helmich, Hallett, Deuschl, Toni, & Bloem, 2012; Liu et al., 2006; Rosin, Topka, & Dichgans, 1997). In the last years, many empirical studies (e.g., Bocanegra et al., 2015; Spadacenta et al., 2012) have also shown that the processing of action verbs is selectively impaired in patients affected by this neurodegenerative disorder. In the light of these findings, it has been suggested that Parkinson disorder can be interpreted within an embodied cognition framework (e.g., Bocanegra et al., 2015). The central tenet of any embodied approach to language and cognition is that high order cognitive functions are grounded in the sensory-motor system. With regard to this point, Gallese (2008) proposed the neural exploitation hypothesis to account for, at the phylogenetic level, how key aspects of human language are underpinned by brain mechanisms originally evolved for sensory-motor integration. Glenberg and Gallese (2012) also applied the neural exploitation hypothesis to the ontogenetic level. On the basis of these premises, they developed a theory of language acquisition according to which, sensory-motor mechanisms provide a neurofunctional architecture for the acquisition of language, while retaining their original functions as well. The neural exploitation hypothesis is here applied to interpret the profile of patients affected by Parkinson's disease. It is suggested that action semantic impairments directly tap onto motor disorders. Finally, a discussion of what theory of language is needed to account for the interactions between language and movement disorders is presented. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Adaptación argentina de la escala de fusión pensamiento-acción: resultados preliminares de su aplicación en pacientes con trastorno obsesivo compulsivo, otros trastornos de ansiedad y población no clínica Argentinian adaptation of the thought action fusion scale: preliminary data about its aplication in obsessive compulsive disorder patients, patients with others anxiety disorders and a non clinical sample

    Directory of Open Access Journals (Sweden)

    Ricardo Rodríguez Biglieri

    2007-12-01

    Full Text Available La presente investigación se inserta en el marco de una tesis doctoral tendiente a evaluar el perfil cognitivo de los pacientes con Trastorno Obsesivo Compulsivo (TOC. Algunos modelos cognitivos sostienen que los pacientes con TOC presentan creencias de tipo fusión pensamiento-acción que predispondrían a la aparición y mantenimiento de los síntomas. Los objetivos del estudio fueron: 1 Realizar una adaptación lingüística y conceptual de la Escala de Fusión Pensamiento-Acción (Thought Action Fusion Scale; Shafran, Thordarson & Rachman, 1996; 2 Obtener datos psicométricos preliminares sobre su confiabilidad y validez. La escala obtenida mediante retrotraducción fue administrada a una muestra de 30 pacientes con TOC, 60 pacientes con otros trastornos de ansiedad y a una muestra no clínica compuesta por 100 sujetos. Los indicadores de consistencia interna, confiabilidad testretest y validez fueron adecuados. En vista de los resultados, se discuten sus implicancias teóricas y clínicas.The outlined investigation was performed in the context of a doctoral thesis aimed on the evaluation of the cognitive profile of Obsessive Compulsive Disorder patients. Some cognitive models support that Obsessive Compulsive Disorder (OCD patients have thought-action fusion beliefs that could predispose to development and maintenance of symptoms. The aim of study was: 1 to make a Spanish adaptation of the Thought-action Fusion Scale (Shafran, Thordarson & Rachman, 1996; 2 to find out preliminary data about their reliability and validity. The back-translated scale was administered to 30 OCD patients, 60 other anxiety disorder patients and to 100 non clinic subjects sample. Internal consistency, repeteability and validity results were approtiated. Theoretical and Clinical implications are discussed.

  17. The Association of Insight and Change in Insight with Clinical Symptoms in Depressed Inpatients.

    Science.gov (United States)

    He, Hongbo; Chang, Qing; Ma, Yarong

    2018-04-25

    Lack of insight has been extensively studied and was found to be adversely correlated with impaired treatment compliance and worse long term clinical outcomes among patients with schizophrenia, while not much is known about this phenonmenon in patients with severe depression. To explore the correlates of insight and its relation to symptom changes among the most seriously ill patients with affective disorders, those who require hospitalization. Patients hospitalized in a large psychiatric hospital in south China with either major depressive disorder (MDD)(N=55) or bipolar depression (BD) (N=85) based on ICD-10 diagnostic criteria were assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ) one week after admission and at the time of discharge. Clinical symptoms were measured at the same time with the Hamilton Rating Scale for Depression (HAMD-17) and the Depression subscale of the Symptom Check list-90 (SCL-90). Length of stay (LOS), duration of illness, duration of untreated mood disorder, number of previous episodes of depression and previous admissions for depression were documented during interviews with patients and their families and from a review of medical records. Bivariate correlations and multiple regression analysis were used to examine the relationship of sociodemographic characteristics, clinical symptomatology and clinical history, to insight at the time of admission. The relationships between change in clinical symptoms and change in insight from admission to discharge were also examined. Stepwise multiple regression models suggested that any previous admissions for depression and higher anxiety factor scores on the HAMD-17 are significant independent predictors of insight accounting for 22.9% of the variance. Multiple regression analysis residual change scores (change scores adjusted for baseline values) on the ITAQ showed that improved insight over average stays of 51 days were inversely related to the residual psychomotor

  18. Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention

    Science.gov (United States)

    Burton, Cynthia Z.; Vella, Lea; Twamley, Elizabeth W.

    2013-01-01

    The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness. In the context of psychosis, both clinical and cognitive insight have been described. This study aimed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning, psychiatric symptom severity, and everyday functioning in patients with a primary psychotic disorder participating in a compensatory cognitive training (CT) intervention. Sixty-nine individuals diagnosed with a primary psychotic disorder were randomized to a 3-month CT intervention or to standard pharmacotherapy, and they completed a comprehensive neuropsychological, clinical, and functional battery at baseline, 3 months, and 6 months. The CT intervention focused on habit formation and compensatory strategy learning in four domains: prospective memory, attention and vigilance, learning and memory, and problem-solving/cognitive flexibility. At baseline, better clinical insight was significantly related to better executive functioning and less severe negative symptoms. There was no significant association between cognitive insight and cognitive functioning, symptom severity, or everyday functioning ability. The CT intervention did not have an effect on clinical or cognitive insight, but better cognitive insight prior to participation in CT significantly predicted decreased positive and depressive symptom severity posttreatment, and better clinical insight predicted improved self-reported quality of life. Although clinical insight is related to executive functioning, the correlates of cognitive insight remain elusive. Intact insight appears to be beneficial in ameliorating clinical symptomatology like positive symptoms and depression, rather than augmenting cognition. It may be valuable to develop brief interventions aimed at improving clinical and cognitive insight prior to other psychosocial rehabilitation in order to maximize the benefit of

  19. Chronic alcoholism: insights from neurophysiology.

    Science.gov (United States)

    Campanella, S; Petit, G; Maurage, P; Kornreich, C; Verbanck, P; Noël, X

    2009-01-01

    Increasing knowledge of the anatomical structures and cellular processes underlying psychiatric disorders may help bridge the gap between clinical signs and basic physiological processes. Accordingly, considerable insight has been gained in recent years into a common psychiatric condition, i.e., chronic alcoholism. We reviewed various physiological parameters that are altered in chronic alcoholic patients compared to healthy individuals--continuous electroencephalogram, oculomotor measures, cognitive event-related potentials and event-related oscillations--to identify links between these physiological parameters, altered cognitive processes and specific clinical symptoms. Alcoholic patients display: (1) high beta and theta power in the resting electroencephalogram, suggesting hyperarousal of their central nervous system; (2) abnormalities in smooth pursuit eye movements, in saccadic inhibition during antisaccade tasks, and in prepulse inhibition, suggesting disturbed attention modulation and abnormal patterns of prefrontal activation that may stem from the same prefrontal "inhibitory" cortical dysfunction; (3) decreased amplitude for cognitive event-related potentials situated along the continuum of information-processing, suggesting that alcoholism is associated with neurophysiological deficits at the level of the sensory cortex and not only disturbances involving associative cortices and limbic structures; and (4) decreased theta, gamma and delta oscillations, suggesting cognitive disinhibition at a functional level. The heterogeneity of alcoholic disorders in terms of symptomatology, course and outcome is the result of various pathophysiological processes that physiological parameters may help to define. These alterations may be related to precise cognitive processes that could be easily monitored neurophysiologically in order to create more homogeneous subgroups of alcoholic individuals.

  20. Insight and its relationship with stigma in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Deepak K Mishra

    2009-01-01

    Full Text Available Background: The literature on insight has paid insufficient attention to the social experiences that are associated with receiving and endorsing a diagnosis of mental illness. The psychological and behavioral commitments associated with insight extend beyond agreeing with a diagnosis and accepting treatment to include taking on the identity of an individual diagnosed with mental illness. This study sought to examine the relationship between insight and stigma in psychiatric patients. Materials and Methods: Cross-sectional assessment of insight and stigma was done using the system adopted by Kaplan and Sadock in their comprehensive textbook of psychiatry and Felt Stigma Scale in 100 psychiatric patients (40 patients suffering from Bipolar affective disorder, 30 Schizophrenics, 20 Substance dependents and 10 with Obsessive Compulsive disorder. Results: It was found that the level of stigma felt by patients with insight was significantly higher than that felt by patients without insight. Conclusion: Though there is a certain extent of stigma present in patients without insight, as is expected, the level of stigma increases as the patients develop insight.

  1. Brain Hypoactivation, Autonomic Nervous System Dysregulation, and Gonadal Hormones in Depression: A Preliminary Study

    Science.gov (United States)

    Holsen, Laura M.; Lee, Jong-Hwan; Spaeth, Sarah B.; Ogden, Lauren A.; Klibanski, Anne; Whitfield-Gabrieli, Susan; Sloan, Richard P.; Goldstein, Jill M.

    2012-01-01

    The comorbidity of major depressive disorder (MDD) and cardiovascular disease (CVD) is among the 10th leading cause of morbidity and mortality worldwide. Thus, understanding the co-occurrence of these disorders will have major public health significance. MDD is associated with an abnormal stress response, manifested in brain circuitry deficits, gonadal dysfunction, and autonomic nervous system (ANS) dysregulation. Contribution of the relationships between these systems to the pathophysiology of MDD is not well understood. The objective of this preliminary study was to investigate, in parallel, relationships between HPG-axis functioning, stress response circuitry activation, and parasympathetic reactivity in healthy controls and women with MDD. Using fMRI with pulse oximetry [from which we calculated the high frequency (HF) component of R-R interval variability (HF-RRV), a measure of parasympathetic modulation] and hormone data, we studied eight women with recurrent MDD in remission and six controls during a stress response paradigm. We demonstrated that hypoactivations of hypothalamus, amygdala, hippocampus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and subgenual ACC were associated with lower parasympathetic cardiac modulation in MDD women. Estradiol and progesterone attenuated group differences in the effect of HF-RRV on hypoactivation in the amygdala, hippocampus, ACC, and OFC in MDD women. Findings have implications for understanding the relationship between mood, arousal, heart regulation, and gonadal hormones, and may provide insights into MDD and CVD risk comorbidity. PMID:22395084

  2. Insight in bipolar mania: evaluation of its heterogeneity and correlation with clinical symptoms.

    Science.gov (United States)

    Silva, Rafael de Assis da; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

    2016-07-15

    Studies on insight in bipolar mania are not numerous and usually consider insight as a unitary construct. Evaluate how different facets of insight are affected in bipolar mania and investigate correlations between insight for each specific object in bipolar disorder and manic symptomatology. A group of 165 bipolar patients were followed during a year, with 51 patients having manic episodes according to DSM-IV-TR criteria. Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. The study found that insight regarding symptoms is worse than insight of having bipolar disorder, social relationships and self esteem. Moreover, poor global insight (total ISAD) correlates with more severe changes in mood, speech and thought structure, with worse insight about symptoms correlating with the same alterations and also with more severe symptoms of agitation/energy. Although a large sample of bipolar patients was followed up, the final sample composed of patients with at least one manic episode was relatively smaller. Moreover, the fact that the study was performed in a university hospital may have led to selection biases. Results suggest that patients with BD are reasonably capable of identifying that their condition implies consequences but have more impaired awareness of their energy and activity levels. A lower level of insight specifically about symptoms correlates with more severe symptoms of agitation/energy, which suggests a psychomotor nucleus able to impair insight in mania. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Matthews, Marguerite; Nigg, Joel T.

    2014-01-01

    Over the last two decades, there have been numerous technical and methodological advances available to clinicians and researchers to better understand attention deficit hyperactivity disorder (ADHD) and its etiology. Despite the growing body of literature investigating the disorder’s pathophysiology, ADHD remains a complex psychiatric disorder to characterize. This chapter will briefly review the literature on ADHD, with a focus on its history, the current genetic insights, neurophysiologic theories, and the use of neuroimaging to further understand the etiology. We address some of the major concerns that remain unclear about ADHD, including subtype instability, heterogeneity, and the underlying neural correlates that define the disorder. We highlight that the field of ADHD is rapidly evolving; the descriptions provided here will hopefully provide a sturdy foundation for which to build and improve our understanding of the disorder. PMID:24214656

  4. Dreaming and insight

    Science.gov (United States)

    Edwards, Christopher L.; Ruby, Perrine M.; Malinowski, Josie E.; Bennett, Paul D.; Blagrove, Mark T.

    2013-01-01

    This paper addresses claims that dreams can be a source of personal insight. Whereas there has been anecdotal backing for such claims, there is now tangential support from findings of the facilitative effect of sleep on cognitive insight, and of REM sleep in particular on emotional memory consolidation. Furthermore, the presence in dreams of metaphorical representations of waking life indicates the possibility of novel insight as an emergent feature of such metaphorical mappings. In order to assess whether personal insight can occur as a result of the consideration of dream content, 11 dream group discussion sessions were conducted which followed the Ullman Dream Appreciation technique, one session for each of 11 participants (10 females, 1 male; mean age = 19.2 years). Self-ratings of deepened self-perception and personal gains from participation in the group sessions showed that the Ullman technique is an effective procedure for establishing connections between dream content and recent waking life experiences, although wake life sources were found for only 14% of dream report text. The mean Exploration-Insight score on the Gains from Dream Interpretation questionnaire was very high and comparable to outcomes from the well-established Hill (1996) therapist-led dream interpretation method. This score was associated between-subjects with pre-group positive Attitude Toward Dreams (ATD). The need to distinguish “aha” experiences as a result of discovering a waking life source for part of a dream, from “aha” experiences of personal insight as a result of considering dream content, is discussed. Difficulties are described in designing a control condition to which the dream report condition can be compared. PMID:24550849

  5. Effectiveness of Service Dogs for Veterans with PTSD: Preliminary Outcomes.

    Science.gov (United States)

    Vincent, Claude; Belleville, Geneviève; Gagnon, Dany H; Dumont, Frédéric; Auger, Edouard; Lavoie, Vicky; Besemann, Markus; Champagne, Noël; Lessart, Geneviève

    2017-01-01

    Limited scientific evidence on the effectiveness of psychiatric service dogs used by Veterans with post-traumatic stress disorder (PTSD) is available. This study investigated their short-term effectiveness among 15 Canadian veterans who received a first psychiatric service dog. Preliminary results suggest potential beneficial effects at 3 months on the psychiatric symptoms.

  6. PTSD and Impaired Eye Expression Recognition: A Preliminary Study

    Science.gov (United States)

    Schmidt, Jakob Zeuthen; Zachariae, Robert

    2009-01-01

    This preliminary study examined whether posttraumatic stress disorder (PTSD) was related to difficulties in identifying the mental states of others in a group of refugees. Sixteen Bosnian refugees, referred to treatment in an outpatient treatment center for survivors of torture and war-related trauma in Denmark (CETT), were compared to 16 non-PTSD…

  7. Development and preliminary validation of a screen for ...

    African Journals Online (AJOL)

    Development and preliminary validation of a screen for interpersonal childhood trauma experiences among school-going youth in Durban, South Africa. ... validity in the sense that all scales were significantly correlated with scores on clinical measures of post-traumatic stress disorder (PTSD) and/or complex PTSD.

  8. Relationships between FTO rs9939609, MC4R rs17782313, and PPARγ rs1801282 polymorphisms and the occurrence of selected metabolic and hormonal disorders in middle-aged and elderly men – a preliminary study

    Directory of Open Access Journals (Sweden)

    Rotter I

    2016-11-01

    Full Text Available Iwona Rotter,1 Karolina Skonieczna-Żydecka,2 Danuta Kosik-Bogacka,3 Grażyna Adler,2 Aleksandra Rył,4 Maria Laszczyńska4 1Department of Medical Rehabilitation, 2Department of Gerontobiology, 3Department of Biology and Medical Parasitology, 4Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland Purpose: Metabolic disorders, including MetS, obesity, and lipid disorders, may be related to genetic factors. Metabolic disorders are associated with decreased TS levels in aging men. The aim of this study was to evaluate the relationship between FTO rs9939609, MC4R rs17782313, and PPARɣ rs1801282 polymorphisms and the presence of MetS and its components, the concurrent lipid disorders, as well as sex hormone concentrations. Subjects and methods: This study involved 272 men of Caucasian descent aged 50–75 years. Lipid profile, including TCh, LDL, HDL, and TG, was evaluated by spectrophotometric method. Anthropometric measurements concerned WC and blood pressure. MetS was diagnosed according to the criteria of the IDF. Sex hormone profile, including TST, FTS, E2, DHEAS, and SHBG, was examined using enzyme-linked immunosorbent assay. Polymorphisms within FTO, MC4R, and PPARɣ genes were identified using polymerase chain reaction-restriction fragments length polymorphism. Results: This study did not show links between the analyzed genetic polymorphisms and the presence of MetS, T2DM, HT, and obesity. However, higher concentrations of TCh and LDL were found in men with the FTO rs9939609 polymorphism in the recessive mode of inheritance (P=0.03 and P=0.05, respectively. Lower WC was found to be associated with MC4R rs17782313 gene inherited in the same model (P=0.005. Conclusion: FTO rs9939609, MC4R rs17782313, and PPARɣ rs1801282 polymorphisms seem to have little effect on the incidence of metabolic malfunctions and no effect on androgen-related disorders in the examined middle-aged and elderly men

  9. OpenGL Insights

    CERN Document Server

    Cozzi, Patrick

    2012-01-01

    Get Real-World Insight from Experienced Professionals in the OpenGL Community With OpenGL, OpenGL ES, and WebGL, real-time rendering is becoming available everywhere, from AAA games to mobile phones to web pages. Assembling contributions from experienced developers, vendors, researchers, and educators, OpenGL Insights presents real-world techniques for intermediate and advanced OpenGL, OpenGL ES, and WebGL developers. Go Beyond the Basics The book thoroughly covers a range of topics, including OpenGL 4.2 and recent extensions. It explains how to optimize for mobile devices, explores the design

  10. World energy insight 2011

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-11-15

    The World Energy Insight 2011 is the official publication of the World Energy Council. It includes interviews, articles and case studies from a distinguished panel of World Energy Council Officers, CEOs, government ministers, academics and opinion formers from all areas of the energy sector and provides perspectives from around the globe. Government, industry and NGO's offer both policy and technology perspectives. The insights within this publication add to the work that WEC is doing to provide the forum for energy leaders, along with the on-going WEC studies and programmes on Energy Policies, 2050 Energy Scenarios, Energy Resources & Technologies, Energy for Urban Innovation, Rules Of Energy Trade and Global Energy Access.

  11. PRA insights applicable to the design of a broad applications test reactor

    International Nuclear Information System (INIS)

    Khericha, S.T.; Reilly, H.J.

    1993-01-01

    Design insights applicable to the design of a new Broad Applications Test Reactor (BATR), studied during Fiscal Years 1992 an d1993 at Idaho National Engineering Laboratory (INEL), are summarized. Sources of design insights include past probabilistic risk assessments (PRAs) and related studies for Department of Energy (DOE)-owned Class A reactors and for commercial reactors. The report includes preliminary risk allocations for the BATR. The survey addressed those design insights that would affect the reactor core damage frequency (CDF). The design insights, while selected specifically for BATR, should be applicable to any new advanced test reactor

  12. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    Science.gov (United States)

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

  13. The "Insight Paradox" in Schizophrenia: Magnitude, Moderators and Mediators of the Association Between Insight and Depression.

    Science.gov (United States)

    Belvederi Murri, Martino; Amore, Mario; Calcagno, Pietro; Respino, Matteo; Marozzi, Valentina; Masotti, Mattia; Bugliani, Michele; Innamorati, Marco; Pompili, Maurizio; Galderisi, Silvana; Maj, Mario

    2016-09-01

    The so-called "insight paradox" posits that among patients with schizophrenia higher levels of insight are associated with increased levels of depression. Although different studies examined this issue, only few took in account potential confounders or factors that could influence this association. In a sample of clinically stable patients with schizophrenia, insight and depression were evaluated using the Scale to assess Unawareness of Mental Disorder and the Calgary Depression Scale for Schizophrenia. Other rating scales were used to assess the severity of psychotic symptoms, extrapyramidal symptoms, hopelessness, internalized stigma, self-esteem, and service engagement. Regression models were used to estimate the magnitude of the association between insight and depression while accounting for the role of confounders. Putative psychological and sociodemographic factors that could act as mediators and moderators were examined using the PROCESS macro. By accounting for the role of confounding factors, the strength of the association between insight into symptoms and depression increased from 13% to 25% explained covariance. Patients with lower socioeconomic status (F = 8.5, P = .04), more severe illness (F = 4.8, P = .03) and lower levels of service engagement (F = 4.7, P = .03) displayed the strongest association between insight and depression. Lastly, hopelessness, internalized stigma and perceived discrimination acted as significant mediators. The relationship between insight and depression should be considered a well established phenomenon among patients with schizophrenia: it seems stronger than previously reported especially among patients with lower socioeconomic status, severe illness and poor engagement with services. These findings may have relevant implications for the promotion of insight among patients with schizophrenia. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved

  14. Preliminary risk assessments of the small HTGR

    International Nuclear Information System (INIS)

    Everline, C.J.; Bellis, E.A.

    1985-05-01

    Preliminary investment and safety risk assessments were performed for a preconceptual design of a four-module 250-MW(t) side-by-side steel-vessel pebble bed HTGR plant. Broad event spectra were analyzed involving component damage resulting in unscheduled plant outages and fission product releases resulting in offsite doses. The preliminary assessment indicates at this stage of the design that two categories of events govern the investment risk envelope: primary coolant leaks which release some circulating and plate-out activity that contaminates the confinement and turbogenerator damage which involves extensive turbine blade failure. Primary coolant leaks are important contributors because associated cleanup and decontamination requirements result in longer outages that arise from other events with comparable frequencies. Turbogenerator damage is the salient low-frequency investment risk accident due to the relatively long outages being experienced in the industry. Thermal transients are unimportant investment risk contributors because pressurized core heatups cause little damage, and depressurized core heatups occur at negligible frequencies relative to the forced outage goal. These preliminary results demonstrate investment and safety risk goal compliance at this stage in the design process. Studies are continuing in order to provide valuable insights into risk-significant events to assure a balanced approach to meeting user and regulatory requirements

  15. New Insights from Inside-Out Doppler Tomography

    Directory of Open Access Journals (Sweden)

    E. J. Kotze

    2015-02-01

    Full Text Available We present preliminary results from our investigation into using an “inside-out” velocity space for creating a Doppler tomogram. The aim is to transpose the inverted appearance of the Cartesian velocity space used in normal Doppler tomography. In a comparison between normal and inside-out Doppler tomograms of cataclysmic variables, we show that the inside-out velocity space has the potential to produce new insights into the accretion dynamics in these systems.

  16. Global China Insights

    NARCIS (Netherlands)

    Segers, Rien; Fischer, Ingrid

    Journal in which the Groningen Confucius Institute (GCI) shares different perspectives on China and provides insights into China from as many different aspects as possible. GCI aims to provide a full view of real China to the readers as well as featuring international and comprehensive perspectives,

  17. Global China Insights

    NARCIS (Netherlands)

    Segers, Rien; Havinga, Marieke; Fischer, Ingrid

    2013-01-01

    Journal in which the Groningen Confucius Institute (GCI) shares different perspectives on China and provides insights into China from as many different aspects as possible. GCI aims to provide a full view of real China to the readers as well as featuring international and comprehensive perspectives,

  18. Africa Insight: Submissions

    African Journals Online (AJOL)

    Author Guidelines. Africa Insight is a quarterly, peer-reviewed journal of the Africa Institute of South Africa (AISA). It is accredited by the Department of Higher ... Abstract: All articles should be accompanied by an abstract of between 100 and 125 words stating the main research problem, major findings and conclusion(s).

  19. Color perception deficits in co-existing attention-deficit/hyperactivity disorder and chronic tic disorders

    NARCIS (Netherlands)

    Roessner, V.; Banaschewski, T.; Fillmer-Otte, A.; Becker, A.; Albrecht, B.; Uebel, H.; Sergeant, J.A.; Tannock, R.; Rothenberger, A.

    2008-01-01

    Preliminary findings suggest that color perception, particularly of blue-yellow stimuli, is impaired in attention-deficit/hyperactivity disorder (ADHD) as well as in chronic tic disorders (CTD). However, these findings have been not replicated and it is unclear what these deficits mean for the

  20. Eating Disorders

    Science.gov (United States)

    ... of-control eating Women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders, and substance abuse. Eating disorders can ...

  1. Eating Disorders

    Science.gov (United States)

    ... Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH Home Research ... About Eating Disorders More Publications About Eating Disorders Research Results PubMed: Journal Articles about Eating Disorders Contact Us The National ...

  2. Personality Disorders

    Science.gov (United States)

    ... Disorders in Adults Data Sources Share Personality Disorders Definitions Personality disorders represent “an enduring pattern of inner ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  3. Schizoaffective Disorder

    Science.gov (United States)

    ... variations in brain chemistry and structure. Risk factors Factors that increase the risk of developing schizoaffective disorder include: Having a close blood relative who has schizoaffective disorder, schizophrenia or bipolar disorder Stressful events that trigger symptoms ...

  4. World energy insight 2011

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-11-15

    The World Energy Insight 2011 is the official publication of the World Energy Council. It includes interviews, articles and case studies from a distinguished panel of World Energy Council Officers, CEOs, government ministers, academics and opinion formers from all areas of the energy sector and provides perspectives from around the globe. Government, industry and NGO's offer both policy and technology perspectives. The insights within this publication add to the work that WEC is doing to provide the forum for energy leaders, along with the on-going WEC studies and programmes on Energy Policies, 2050 Energy Scenarios, Energy Resources & Technologies, Energy for Urban Innovation, Rules Of Energy Trade and Global Energy Access.

  5. The politics of insight

    OpenAIRE

    Salvi, Carola; Cristofori, Irene; Grafman, Jordan; Beeman, Mark

    2016-01-01

    Previous studies showed that liberals and conservatives differ in cognitive style. Liberals are more flexible, and tolerant of complexity and novelty, whereas conservatives are more rigid, are more resistant to change, and prefer clear answers. We administered a set of compound remote associate problems, a task extensively used to differentiate problem-solving styles (via insight or analysis). Using this task, several researches have proven that self-reports, which differentiate between insig...

  6. HPC Insights, Fall 2011

    Science.gov (United States)

    2011-01-01

    Power 6 ( Davinci ) systems. We have also made use of the Air Force Research Laboratory DSRC Altix (Hawk) and the Engineer Research and Development...the design and development of high performance gas turbine combustion systems both as a pretest analysis tool to predict static and dynamic...application while gaining insight into MATLAB’s value as an engineering tool . I would like to thank the MHPCC and the Akamai Workforce Initiative

  7. Somatic symptom disorder

    Science.gov (United States)

    ... related disorders; Somatization disorder; Somatiform disorders; Briquet syndrome; Illness anxiety disorder References American Psychiatric Association. Somatic symptom disorder. Diagnostic and Statistical Manual of Mental Disorders . ...

  8. The politics of insight.

    Science.gov (United States)

    Salvi, Carola; Cristofori, Irene; Grafman, Jordan; Beeman, Mark

    2016-01-01

    Previous studies showed that liberals and conservatives differ in cognitive style. Liberals are more flexible, and tolerant of complexity and novelty, whereas conservatives are more rigid, are more resistant to change, and prefer clear answers. We administered a set of compound remote associate problems, a task extensively used to differentiate problem-solving styles (via insight or analysis). Using this task, several researches have proven that self-reports, which differentiate between insight and analytic problem-solving, are reliable and are associated with two different neural circuits. In our research we found that participants self-identifying with distinct political orientations demonstrated differences in problem-solving strategy. Liberals solved significantly more problems via insight instead of in a step-by-step analytic fashion. Our findings extend previous observations that self-identified political orientations reflect differences in cognitive styles. More specifically, we show that type of political orientation is associated with problem-solving strategy. The data converge with previous neurobehavioural and cognitive studies indicating a link between cognitive style and the psychological mechanisms that mediate political beliefs.

  9. The politics of insight

    Science.gov (United States)

    Salvi, Carola; Cristofori, Irene; Grafman, Jordan; Beeman, Mark

    2016-01-01

    Previous studies showed that liberals and conservatives differ in cognitive style. Liberals are more flexible, and tolerant of complexity and novelty, whereas conservatives are more rigid, are more resistant to change, and prefer clear answers. We administered a set of compound remote associate problems, a task extensively used to differentiate problem-solving styles (via insight or analysis). Using this task, several researches have proven that self-reports, which differentiate between insight and analytic problem-solving, are reliable and are associated with two different neural circuits. In our research we found that participants self-identifying with distinct political orientations demonstrated differences in problem-solving strategy. Liberals solved significantly more problems via insight instead of in a step-by-step analytic fashion. Our findings extend previous observations that self-identified political orientations reflect differences in cognitive styles. More specifically, we show that type of political orientation is associated with problem-solving strategy. The data converge with previous neurobehavioural and cognitive studies indicating a link between cognitive style and the psychological mechanisms that mediate political beliefs. PMID:26810954

  10. Eating disorders in women

    Science.gov (United States)

    Sharan, Pratap; Sundar, A. Shyam

    2015-01-01

    Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646

  11. UVISS preliminary visibility analysis

    DEFF Research Database (Denmark)

    Betto, Maurizio

    1998-01-01

    The goal of this work is to obtain a preliminary assessment of the sky visibility for anastronomical telescope located on the express pallet of the International SpaceStation (ISS)} taking into account the major constraints imposed on the instrument by the ISSattitude and structure. Part of the w......The goal of this work is to obtain a preliminary assessment of the sky visibility for anastronomical telescope located on the express pallet of the International SpaceStation (ISS)} taking into account the major constraints imposed on the instrument by the ISSattitude and structure. Part...... of the work is also to setup the kernel of a software tool for the visibility analysis thatshould be easily expandable to consider more complex strucures for future activities.This analysis is part of the UVISS assessment study and it is meant to provide elementsfor the definition and the selection...

  12. Epidemiology of major depressive disorder

    NARCIS (Netherlands)

    Stegenga, B.T.

    2011-01-01

    Major depressive disorder (MDD) is a serious health problem and will be the second leading cause of burden of disease worldwide by 2030. To be able to prevent MDD, insight into risk factors for the onset of MDD is of clear importance. On the other hand, if onset of MDD has occurred, one may argue

  13. What are System Dynamics Insights?

    OpenAIRE

    Stave, K.; Zimmermann, N. S.; Kim, H.

    2016-01-01

    This paper explores the concept of system dynamics insights. In our field, the term “insight” is generally understood to mean dynamic insight, that is, a deep understanding about the relationship between structure and behavior. We argue this is only one aspect of the range of insights possible from system dynamics activities, and describe a broader range of potential system dynamics insights. We also propose an initial framework for discussion that relates different types of system dynamics a...

  14. Antares: preliminary demonstrator results

    International Nuclear Information System (INIS)

    Kouchner, A.

    2000-05-01

    The ANTARES collaboration is building an undersea neutrino telescope off Toulon (Mediterranean sea) with effective area ∼ 0.1 km 2 . An extensive study of the site properties has been achieved together with software analysis in order to optimize the performance of the detector. Results are summarized here. An instrumented line, linked to shore for first time via an electro-optical cable, has been immersed late 1999. The preliminary results of this demonstrator line are reported. (author)

  15. Neuroimaging results, short-term assessment of psychomotor development and the risk of autism spectrum disorder in extremely premature infants (≤28 GA) - a prospective cohort study (preliminary report).

    Science.gov (United States)

    Rutkowska, Magdalena; Bekiesińska-Figatowska, Monika; Kmita, Grażyna; Terczyńska, Iwona; Polak, Katarzyna; Kalisiak, Marcin; Prażmowska, Dorota; Kiepura, Eliza; Szkudlińska-Pawlak, Sylwia; Seroczyńska, Małgorzata; Helwich, Ewa

    2018-01-01

    Infants ≤28 GA are at particular risk of psychomotor and neurological developmental disorder. They also remain at a higher risk of developing autism spectrum disorder (ASD), characterized by persistent deficits in communication/social interactions and restricted, repetitive behaviors, activities and interests. Monitoring their development by a team of specialists (a neurologist, psychologist, psychiatrist) allows us to make an early diagnosis and to implement appropriate therapy. Neuroimaging studies during the neonatal period may be helpful in clarifying diagnosis and prognosis. Objective: The aim of the study was to search for the interrelation between the results of neuroimaging and the neurological, psychological and psychiatric evaluation at the age of 2. Material and methods: Neonates born at ≤28 weeks between 01.06.2013 and 31.12.2015 and hospitalized at NICU were enrolled. We present the results of the first 12 children who have attained 2 years of corrected age and have undergone both neuroimaging, and neurological, psychological and psychiatric assessments. Transfontanel ultrasound was performed according to general standards, MRI between 38 and 42 weeks of corrected age. Neurological examination based on the Denver scale, ASD screening with use of the STAT test and psychological DSR assessment were performed at 2 years of corrected age. Results: Median GA was 26 weeks and median weight 795 g. The ultrasound examination was normal in 9 cases (75%) and MRI in 4 (33%). Abnormalities in the cerebellum were the main additional information found in MRI as compared to US. Neurological examination was normal in 8 infants (67#37;), in 4 of whom neuroimaging was normal. In 4 (33%) infants the neurological examination was abnormal. Psychomotor development at an average level or above was found in seven (58#37;) children. In 4 of them neuroimaging was normal, whereas 3 had ventricular dilatation and haemorrhagic infarct. There were no abnormalities within the

  16. Preliminary examination of the impact of traumatic brain injury and posttraumatic stress disorder on self-regulated learning and academic achievement among military service members enrolled in postsecondary education.

    Science.gov (United States)

    Ness, Bryan M; Vroman, Kerryellen

    2014-01-01

    Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members. Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools. Public universities that are members of the Servicemember Opportunity College consortium. Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement. Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA). There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank. The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.

  17. Modulation of brain response to emotional conflict as a function of current mood in bipolar disorder: preliminary findings from a follow-up state-based fMRI study.

    Science.gov (United States)

    Rey, Gwladys; Desseilles, Martin; Favre, Sophie; Dayer, Alexandre; Piguet, Camille; Aubry, Jean-Michel; Vuilleumier, Patrik

    2014-08-30

    We used functional magnetic resonance imaging (fMRI) to examine affective control longitudinally in a group of patients with bipolar disorder (BD). Participants comprised 12 BD patients who underwent repeated fMRI scans in euthymic (n=11), depressed (n=9), or hypomanic (n=9) states, and were compared with 12 age-matched healthy controls. During fMRI, participants performed an emotional face-word interference task with either low or high attentional demands. Relative to healthy controls, patients showed decreased activation of the cognitive control network normally associated with conflict processing, more severely during hypomania than during depression, but regardless of level of task demand in both cases. During euthymia, a decreased response to conflict was observed only during the high load condition. Additionally, unlike healthy participants, patients exhibited deactivation in several key areas in response to emotion-conflict trials - including the rostral anterior cingulate cortex during euthymia, the hippocampus during depression, and the posterior cingulate cortex during hypomania. Our results indicate that the ability of BD patients to recruit control networks when processing affective conflict, and the abnormal suppression of activity in distinct components of the default mode network, may depend on their current clinical state and attentional demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. The relationship between insight and subjective experience in schizophrenia

    Directory of Open Access Journals (Sweden)

    Kako Y

    2014-07-01

    Full Text Available Yuki Kako, Koki Ito, Naoki Hashimoto, Kuniyoshi Toyoshima, Yusuke Shimizu, Nobuyuki Mitsui, Yutaka Fujii, Teruaki Tanaka, Ichiro Kusumi Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan Objectives: To examine the relationship between level of insight and various subjective experiences for patients with schizophrenia.Materials and methods: Seventy-four patients with schizophrenia who were discharged from our hospital were evaluated. The level of insight into their illness and various subjective experiences were evaluated at discharge. We used the Scale to Assess Unawareness of Mental Disorder (SUMD for evaluation of insight. In addition, five different rating scales were used to evaluate subjective experiences: Subjective Experience of Deficits in Schizophrenia (SEDS, Subjective Well-being under Neuroleptic drug treatment Short form (SWNS, Schizophrenia Quality of Life Scale (SQLS, Beck Depression Inventory (BDI, and the Drug Attitude Inventory (DAI-30.Results: The SWNS and the scores for awareness of mental disorder and awareness of the social consequences of mental disorder on SUMD showed a weak positive correlation. The DAI-30 showed a significant negative correlation with most general items on SUMD and a negative correlation between the subscale scores for the awareness and attribution of past symptoms. SEDS, SWNS, SQLS, and the BDI significantly correlated with the subscale scores for awareness of current symptoms on SUMD, and weakly correlated with the subscale scores for attribution of current negative symptoms.Conclusion: Awareness of subjective distress was related to awareness of having a mental disorder. Feeling subjective distress was related to awareness of current symptoms, as well as to the ability to attribute current negative symptoms to a mental disorder. Positive attitudes toward medication correlated with better general insight into the illness. Keywords: schizophrenia, insight

  19. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V.

    Science.gov (United States)

    Stein, Dan J; Grant, Jon E; Franklin, Martin E; Keuthen, Nancy; Lochner, Christine; Singer, Harvey S; Woods, Douglas W

    2010-06-01

    In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder. (c) 2010 Wiley-Liss, Inc.

  20. Brief Report: Insight into Illness and Social Attributional Style in Asperger's Syndrome

    Science.gov (United States)

    Didehbani, Nyaz; Shad, Mujeeb U.; Kandalaft, Michelle R.; Allen, Tandra T.; Tamminga, Carol A.; Krawczyk, Daniel C.; Chapman, Sandra B.

    2012-01-01

    A number of psychiatric illnesses have been recognized to have some level of insight deficits, including developmental disorders, such as Asperger's Syndrome (ASP). However insight into illness has not been empirically investigated in ASP and little research has examined how individuals with ASP view their deficits. This is the first study to…

  1. Association of serotonin transporter (SLC6A4 & receptor (5HTR1A, 5HTR2A polymorphisms with response to treatment with escitalopram in patients with major depressive disorder : A preliminary study

    Directory of Open Access Journals (Sweden)

    Aniruddha Basu

    2015-01-01

    Full Text Available Background & objectives: Genetic factors have potential of predicting response to antidepressants in patients with major depressive disorder (MDD. In this study, an attempt was made to find an association between response to escitalopram in patients with MDD, and serotonin transporter (SLC6A4 and receptor (5HTR1A, 5HTR2A polymorphisms. Methods: Fifty five patients diagnosed as suffering from MDD, were selected for the study. The patients were treated with escitalopram over a period of 6-8 wk. Severity of depression, response to treatment and side effects were assessed using standardised instruments. Genetic variations from HTR1A (rs6295, HTR2A (rs6311 and rs6313 and SLC6A4 (44 base-pair insertion/deletion at 5-HTTLPR were genotyped. The genetic data of the responders and non-responders were compared to assess the role of genetic variants in therapeutic outcome. Results: Thirty six (65.5% patients responded to treatment, and 19 (34.5% had complete remission. No association was observed for genotype and allelic frequencies of single nucleotide polymorphisms (SNPs among remitter/non-remitter and responder/non-responder groups, and six most common side-effects, except memory loss which was significantly associated with rs6311 ( p0 =0.03. Interpretation & conclusions: No significant association was found between the SNPs analysed and response to escitalopram in patients with MDD though a significant association was seen between the side effect of memory loss and rs6311. Studies with larger sample are required to find out genetic basis of antidepressant response in Indian patients.

  2. Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study.

    Science.gov (United States)

    Amianto, Federico; Ferrero, Andrea; Pierò, Andrea; Cairo, Elisabetta; Rocca, Giuseppe; Simonelli, Barbara; Fassina, Simona; Abbate-Daga, Giovanni; Fassino, Secondo

    2011-11-21

    Individuals affected by severe Borderline Personality Disorder (BPD) are often heavy users of Mental Health Services (MHS). Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP) to Supervised Team Management (STM) in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18) and then compared. Clinical Global Impression (CGI) and CGI-modified (CGI-M) for BPD, Global Assessment of Functioning (GAF), State-Trait Anger Expression Inventory (STAXI), and Symptom Checklist-90 Revised (SCL-90-R) were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S) was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time-limited and focused psychotherapy was found to achieve a

  3. Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study

    Directory of Open Access Journals (Sweden)

    Amianto Federico

    2011-11-01

    Full Text Available Abstract Background Individuals affected by severe Borderline Personality Disorder (BPD are often heavy users of Mental Health Services (MHS. Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP to Supervised Team Management (STM in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Methods Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18 and then compared. Clinical Global Impression (CGI and CGI-modified (CGI-M for BPD, Global Assessment of Functioning (GAF, State-Trait Anger Expression Inventory (STAXI, and Symptom Checklist-90 Revised (SCL-90-R were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. Results All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Conclusions Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time

  4. Environmental Survey preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    1988-04-01

    This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Sandia National Laboratories conducted August 17 through September 4, 1987. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Sandia National Laboratories-Albuquerque (SNLA). The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at SNLA, and interviews with site personnel. 85 refs., 49 figs., 48 tabs.

  5. Ruiz Volcano: Preliminary report

    Science.gov (United States)

    Ruiz Volcano, Colombia (4.88°N, 75.32°W). All times are local (= GMT -5 hours).An explosive eruption on November 13, 1985, melted ice and snow in the summit area, generating lahars that flowed tens of kilometers down flank river valleys, killing more than 20,000 people. This is history's fourth largest single-eruption death toll, behind only Tambora in 1815 (92,000), Krakatau in 1883 (36,000), and Mount Pelée in May 1902 (28,000). The following briefly summarizes the very preliminary and inevitably conflicting information that had been received by press time.

  6. Defining resilience: A preliminary integrative literature review

    Science.gov (United States)

    Wilt, Bonnie; Long, Suzanna K.; Shoberg, Thomas G.

    2016-01-01

    The term “resilience” is ubiquitous in technical literature; it appears in numerous forms, such as resilience, resiliency, or resilient, and each use may have a different definition depending on the interpretation of the writer. This creates difficulties in understanding what is meant by ‘resilience’ in any given use case, especially in discussions of interdisciplinary research. To better understand this problem, this research constructs a preliminary integrative literature review to map different definitions, applications and calculation methods of resilience invoked within critical infrastructure applications. The preliminary review uses a State-of-the-Art Matrix (SAM) analysis to characterize differences in definition across disciplines and between regions. Qualifying the various usages of resilience will produce a greater precision in the literature and a deeper insight into types of data required for its evaluation, particularly with respect to critical infrastructure calculations and how such data may be analyzed. Results from this SAM analysis will create a framework of key concepts as part of the most common applications for “resilient critical infrastructure” modeling.

  7. Dissociation - a preliminary contextual model

    Directory of Open Access Journals (Sweden)

    C Krüger

    2007-02-01

    Full Text Available Background. The Diagnostic and Statistical Manual of Mental Disorders (DSM system has certain limitations when applied to two South African examples of dissociation, because it is descriptive (non-explanatory and focuses on intrapsychic (non-communal processes. Even the existing Western explanatory models of dissociation fail to accommodate fully the communal aspects of dissociation in our South African context. Objectives and methods. The aim was to explore an expanded perspective on dissociation that does not limit it to an intrapsychic phenomenon, but that accounts for the interrelatedness of individuals within their social context. Auto-ethnography was used. In this article a collective, socially orientated, contextual hermeneutic was applied to two local examples of dissociation. Three existing Western models were expanded along multicontextual, collective lines, for them to be more useful in the pluralistic South African context. Results. This preliminary contextual model of dissociation includes a person’s interpersonal, socio-cultural, and spiritual contexts, in addition to the intrapsychic context. Dissociation is considered to be a normal information-processing tool that maintains balanced, coherent selves-in-society, i.e. individuals connected to each other. In the South African context dissociation appears mostly as a normal phenomenon and seldom as a sign of mental illness. Dissociation is pivotal for the normal construction of individual and communal identities in the face of conflicting sets of information from various contexts. Dissociation may help individuals or communities to survive in a world of conflicting messages, where conflict is often interpersonal/cultural/societal in nature, rather than primarily intrapsychic. Conclusions. This model should be developed and evaluated further. Such evaluation would require suitable new local terminology.

  8. Insights on STEM Careers

    Energy Technology Data Exchange (ETDEWEB)

    Wendelberger, Joanne Roth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-11-05

    This presentation will provide career advice for individuals seeking to go beyond just having a job to building a successful career in the areas of Science, Technology, Engineering, and Mathematics. Careful planning can be used to turn a job into a springboard for professional advancement and personal satisfaction. Topics to be addressed include setting priorities, understanding career ladders, making tough choices, overcoming stereotypes and assumptions by others, networking, developing a professional identify, and balancing a career with family and other personal responsibilities. Insights on the transition from individual technical work to leadership will also be provided. The author will draw upon experiences gained in academic, industrial, and government laboratory settings, as well as extensive professional service and community involvement.

  9. Osho - Insights on sex.

    Science.gov (United States)

    Nagaraj, Anil Kumar Mysore

    2013-01-01

    Sex is a mysterious phenomenon, which has puzzled even great sages. Human beings have researched and mastered the biology of sex. But that is not all. Sex needs to be understood from the spiritual perspective too. The vision of Osho is an enlightening experience in this regard. Out of the thousands of lectures, five lectures on sex made Osho most notorious. Born into a Jain family of Madhya Pradesh, Rajneesh, who later wanted himself to be called Osho, is a great master. He has spoken volumes on a wide range of topics ranging from sex to super-consciousness. His contributions in the area of sex are based on the principles of "Tantra" which has its origin from Buddhism. This article focuses on his life and insights on sex, which if understood properly, can be a stepping stone for enlightenment.

  10. Outsourcing/Offshoring Insights

    DEFF Research Database (Denmark)

    Tate, Wendy; Bals, Lydia

    2017-01-01

    Findings: Both the geographical and governance dimensions are part of the rightshoring decision which is an important conceptual foundation for this special issue, as it invited insightful pieces on all of these phenomena (e.g. outsourcing, insourcing, offshoring, reshoring), acknowledging...... for future research out of the six papers are summarized in Table III. There is ample opportunity to further shed light on these suggestions as well as to cover parts of the “rightshoring” framework presented, that remain less covered here (e.g. insourcing and/or reshoring). Practical implications: The array...... of potential “rightshoring” options fosters clarity about the phenomena studied and their implications. The main practical implications of the six papers are summarized in Table II. Originality/value: The overall conceptual framework highlights the positioning of the final papers included into the special...

  11. Elimination diets' efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder

    NARCIS (Netherlands)

    Ly, Verena; Bottelier, Marco; Hoekstra, Pieter J.; Vasquez, Alejandro Arias; Buitelaar, Jan K.; Rommelse, Nanda N.

    Nutrition plays an important role in neurodevelopment. This insight has led to increasing research into the efficacy of nutrition-related interventions for treating neurodevelopmental disorders. This review discusses an elimination diet as a treatment for attention deficit hyperactivity disorder and

  12. OMEGA Upgrade preliminary design

    International Nuclear Information System (INIS)

    Craxton, R.S.

    1989-10-01

    The OMEGA laser system at the Laboratory for Laser Energetics of the University of Rochester is the only major facility in the United States capable of conducting fully diagnosed, direct-drive, spherical implosion experiments. As such, it serves as the national Laser Users Facility, benefiting scientists throughout the country. The University's participation in the National Inertial Confinement Fusion (ICF) program underwent review by a group of experts under the auspices of the National Academy of Sciences (the Happer Committee) in 1985. The Happer Committee recommended that the OMEGA laser be upgraded in energy to 30 kJ. To this end, Congress appropriated $4,000,000 for the preliminary design of the OMEGA Upgrade, spread across FY88 and FY89. This document describes the preliminary design of the OMEGA Upgrade. The proposed enhancements to the existing OMEGA facility will result in a 30-kHJ, 351-nm, 60-beam direct-drive system, with a versatile pulse-shaping facility and a 1%--2% uniformity of target drive. The Upgrade will allow scientists to explore the ignition-scaling regime, and to study target behavior that is hydrodynamically equivalent to that of targets appropriate for a laboratory microfusion facility (LMF). In addition, it will be possible to perform critical interaction experiments with large-scale-length uniformly irradiated plasmas

  13. Insight, Neurocognition, and Schizophrenia: Predictive Value of the Wisconsin Card Sorting Test

    Science.gov (United States)

    Yanos, Philip T.

    2013-01-01

    Lack of insight in schizophrenia is a key feature of the illness and is associated with both positive and negative clinical outcomes. Previous research supports that neurocognitive dysfunction is related to lack of insight, but studies have not examined how neurocognition relates to change in insight over time. Therefore, the current study sought to understand how performance on the Wisconsin Card Sorting Test (WCST) differed between participants with varying degrees of change in insight over a 6-month period. Fifty-two patients with schizophrenia or schizoaffective disorder were administered the WCST and Positive and Negative Syndrome Scale (PANSS) at baseline, and the PANSS was again administered at a 6-month follow-up assessment. Results indicated that while neurocognition was related to insight at baseline, it was not related to subsequent change in insight. The implications of findings for conceptualization and assessment of insight are discussed. PMID:24303216

  14. Anxiety Disorders

    Science.gov (United States)

    ... the death of a loved one or parents' divorce) and major life transitions (like moving to a ... Ways to Deal With Anxiety Dealing With Difficult Emotions Anxiety Disorders Posttraumatic Stress Disorder Fears and Phobias ...

  15. Bipolar Disorder

    Science.gov (United States)

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go ... The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  16. Mathematics disorder

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001534.htm Mathematics disorder To use the sharing features on this page, please enable JavaScript. Mathematics disorder is a condition in which a child's ...

  17. Personality Disorders

    Science.gov (United States)

    Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...

  18. Cephalic Disorders

    Science.gov (United States)

    ... destructive lesions, but are sometimes the result of abnormal development. The disorder can occur before or after birth. Porencephaly most ... decade of life. SCHIZENCEPHALY is a rare developmental disorder characterized by abnormal slits, or clefts, in the cerebral hemispheres. Schizencephaly ...

  19. Oppositional defiant disorder

    Science.gov (United States)

    ... as possibilities: Anxiety disorders Attention-deficit/hyperactivity disorder (ADHD) Bipolar disorder Depression Learning disorders Substance abuse disorders Treatment The best treatment for the child is to ...

  20. Panic Disorder and Women

    Science.gov (United States)

    ... health illnesses Alcoholism, substance abuse, and addictive behavior Anxiety disorders Attention deficit hyperactivity disorder Bipolar disorder (manic depressive illness) Borderline personality disorder Depression Eating disorders Post-traumatic ...

  1. Eating Disorders

    OpenAIRE

    Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E

    2004-01-01

    Abstract Health Issue Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. Key Issues Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and...

  2. MicroRNAs in CAG trinucleotide repeat expansion disorders: an integrated review of the literature.

    Science.gov (United States)

    Dumitrescu, Laura; Popescu, Bogdan O

    2015-01-01

    MicroRNAs are small RNAs involved in gene silencing. They play important roles in transcriptional regulation and are selectively and abundantly expressed in the central nervous system. A considerable amount of the human genome is comprised of tandem repeating nucleotide streams. Several diseases are caused by above-threshold expansion of certain trinucleotide repeats occurring in a protein-coding or non-coding region. Though monogenic, CAG trinucleotide repeat expansion disorders have a complex pathogenesis, various combinations of multiple coexisting pathways resulting in one common final consequence: selective neurodegeneration. Mutant protein and mutant transcript gain of toxic function are considered to be the core pathogenic mechanisms. The profile of microRNAs in CAG trinucleotide repeat disorders is scarcely described, however microRNA dysregulation has been identified in these diseases and microRNA-related intereference with gene expression is considered to be involved in their pathogenesis. Better understanding of microRNAs functions and means of manipulation promises to offer further insights into the pathogenic pathways of CAG repeat expansion disorders, to point out new potential targets for drug intervention and to provide some of the much needed etiopathogenic therapeutic agents. A number of disease-modifying microRNA silencing strategies are under development, but several implementation impediments still have to be resolved. CAG targeting seems feasible and efficient in animal models and is an appealing approach for clinical practice. Preliminary human trials are just beginning.

  3. Insights into business student's book

    CERN Document Server

    Lannon, Michael; Trappe, Tonya

    1993-01-01

    With Challenging reading and listening texts from a range of authentic business sources, New Insights into Business will really engage your students. The thorough language and vocabulary syllabus together with the strong focus on business skills development gives students everything they need to function effectively in the workplace. New Insights into Business is a self-contained course and is also an ideal follow-on to First Insights into Business.

  4. Bipolar Disorder.

    Science.gov (United States)

    Spearing, Melissa

    Bipolar disorder, a brain disorder that causes unusual shifts in a person's mood, affects approximately one percent of the population. It commonly occurs in late adolescence and is often unrecognized. The diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and when possible, family history. Thoughts of suicide are…

  5. MRI in neuromuscular disorders

    International Nuclear Information System (INIS)

    Fischmann, Arne

    2014-01-01

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  6. Speech disorders - children

    Science.gov (United States)

    ... disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering ... evaluation tools that can help identify and diagnose speech disorders: Denver Articulation Screening Examination Goldman-Fristoe Test of ...

  7. Stereotyped movement disorder in ICD-11.

    Science.gov (United States)

    Stein, Dan J; Woods, Douglas W

    2014-01-01

    According to current proposals for ICD-11, stereotyped movement disorder will be classified in the grouping of neurodevelopmental disorders, with a qualifier to indicate whether self-injury is present, similar to the classification of stereotypic movement disorder in DSM-5. At the same time, the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders has proposed a grouping of body-focused repetitive behavior disorders within the obsessive-compulsive and related disorders (OCRD) cluster to include trichotillomania and skin-picking disorder. DSM-5 has taken a slightly different approach: trichotillomania and excoriation (skin picking) disorder are included in the OCRD grouping, while body-focused repetitive behavior disorder is listed under other specified forms of OCRD. DSM-5 also includes a separate category of nonsuicidal self-injury in the section on "conditions for further study." There are a number of unresolved nosological questions regarding the relationships among stereotyped movement disorder, body-focused repetitive behavior disorders, and nonsuicidal self-injury. In this article, we attempt to provide preliminary answers to some of these questions as they relate to the ICD-11 classification of mental and behavioral disorders.

  8. Bipolar disorders

    DEFF Research Database (Denmark)

    Vieta, Eduard; Berk, Michael; Schulze, Thomas G

    2018-01-01

    Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease...... and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand...... a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary....

  9. Epidemiology of major depressive disorder

    OpenAIRE

    Stegenga, B.T.

    2011-01-01

    Major depressive disorder (MDD) is a serious health problem and will be the second leading cause of burden of disease worldwide by 2030. To be able to prevent MDD, insight into risk factors for the onset of MDD is of clear importance. On the other hand, if onset of MDD has occurred, one may argue that different course patterns of MDD can be identified and that it is essential to examine their relationship to symptoms and function over time. Insight into these course patterns could assist in p...

  10. Preliminary rail access study

    International Nuclear Information System (INIS)

    1990-01-01

    The Yucca Mountain site, located on the southwestern edge of the Nevada Test Site, is an undeveloped area under investigation as a potential site for nuclear waste disposal by the US Department of Energy. The site currently lacks rail service and an existing rail right-of-way. If the site is suitable and selected for development as a disposal site, rail service is desirable to the Office of Civilian Radioactive Waste Management Program because of the potential of rail to reduce number of shipments and costs relative to highway transportation. This preliminary report is a summary of progress to date for activities to identify and evaluate potential rail options from major rail carriers in the region to the Yucca Mountain site. It is currently anticipated that the rail spur will be operational after the year 2000. 9 refs., 13 figs., 2 tabs

  11. LM-OSL from single grains of quartz: A preliminary study

    DEFF Research Database (Denmark)

    Bulur, E.; Duller, G.A.T.; Solongo, S.

    2002-01-01

    the easy-to-bleach component, those with only the hard-to-bleach component, and those exhibiting all components. The results of this preliminary study show that LM-OSL experiments carried out at the single grain level may give important insights into the luminescence properties observed when viewing...

  12. Preliminary perspectives gaines from individual plant examination of external events (IPEEE) seismic and fire submittal review

    International Nuclear Information System (INIS)

    Chen, J.T.; Connell, E.; Chokshi, N.

    1997-01-01

    As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals

  13. Abnormal Sensory Experiences, Synaesthesia, and Neurodevelopmental Disorders

    Science.gov (United States)

    Fluegge, Keith

    2017-01-01

    Preliminary evidence suggests that sensory processing may be affected in autism spectrum disorders (ASD). The purpose of this letter is to highlight a few recent studies on the topic and tie the findings to a recently identified epidemiological risk factor for ASD, principally environmental exposure to the air pollutant, nitrous oxide (N[subscript…

  14. Insights into PRA methodologies

    International Nuclear Information System (INIS)

    Gallagher, D.; Lofgren, E.; Atefi, B.; Liner, R.; Blond, R.; Amico, P.

    1984-08-01

    Probabilistic Risk Assessments (PRAs) for six nuclear power plants were examined to gain insight into how the choice of analytical methods can affect the results of PRAs. The PRA sreflectope considered was limited to internally initiated accidents sequences through core melt. For twenty methodological topic areas, a baseline or minimal methodology was specified. The choice of methods for each topic in the six PRAs was characterized in terms of the incremental level of effort above the baseline. A higher level of effort generally reflects a higher level of detail or a higher degree of sophistication in the analytical approach to a particular topic area. The impact on results was measured in terms of how additional effort beyond the baseline level changed the relative importance and ordering of dominant accident sequences compared to what would have been observed had methods corresponding to the baseline level of effort been employed. This measure of impact is a more useful indicator of how methods affect perceptions of plant vulnerabilities than changes in core melt frequency would be. However, the change in core melt frequency was used as a secondary measure of impact for nine topics where availability of information permitted. Results are presented primarily in the form of effort-impact matrices for each of the twenty topic areas. A suggested effort-impact profile for future PRAs is presented

  15. Grigor Narekatsi's astronomical insights

    Science.gov (United States)

    Poghosyan, Samvel

    2015-07-01

    What stand out in the solid system of Gr. Narekatsi's naturalistic views are his astronomical insights on the material nature of light, its high speed and the Sun being composed of "material air". Especially surprising and fascinating are his views on stars and their clusters. What astronomers, including great Armenian academician V. Ambartsumian (scattering of stellar associations), would understand and prove with much difficulty thousand years later, Narekatsi predicted in the 10th century: "Stars appear and disappear untimely", "You who gather and scatter the speechless constellations, like a flock of sheep". Gr. Narekatsti's reformative views were manifested in all the spheres of the 10th century social life; he is a reformer of church life, great language constructor, innovator in literature and music, freethinker in philosophy and science. His ideology is the reflection of the 10th century Armenian Renaissance. During the 9th-10th centuries, great masses of Armenians, forced to migrate to the Balkans, took with them and spread reformative ideas. The forefather of the western science, which originated in the period of Reformation, is considered to be the great philosopher Nicholas of Cusa. The study of Gr. Narekatsti's logic and naturalistic views enables us to claim that Gr. Narekatsti is the great grandfather of European science.

  16. O insight em psiquiatria

    Directory of Open Access Journals (Sweden)

    Ana Margarida P. Cardoso

    2008-12-01

    Full Text Available O sinal de que algo está a acontecer contribui para que o paciente reconheça que alguma coisa de estranho se está a passar consigo. Este reconhecimento faz com que o sujeito possa desempenhar uma função activa e seja um elemento colaborante do seu processo de recuperação. Cada doença apresenta, contudo, diferentes sintomas, uma vez que cada doença psiquiátrica consiste em diferentes perturbações com diversos efeitos sobre o funcionamento mental. Desta maneira, o fenómeno do insight que é registado em cada doença é diferente e expressa-se sob diferentes formas, não somente devido às manifestações clínicas da doença mas também devido às características individuais do sujeito.

  17. Hyperons: Insights into baryon structures

    International Nuclear Information System (INIS)

    Lach, J.

    1991-08-01

    The baryon octet is composed mainly of hyperons. Modern high energy hyperon beams provide a tool for the study of hyperon static properties and interactions. Experiments with these beams have provided new insights into hyperon rare decays, magnetic moments, and interactions. These experiments provide us with insights into the strong, weak, and electromagnetic structure of the baryons. 65 refs., 45 figs., 5 tabs

  18. Childhood onset neuropsychiatric disorders in adult eating disorder patients. A pilot study.

    Science.gov (United States)

    Wentz, Elisabet; Lacey, J Hubert; Waller, Glenn; Råstam, Maria; Turk, Jeremy; Gillberg, Christopher

    2005-12-01

    Autism spectrum disorders (ASD) have been suggested to be overrepresented in anorexia nervosa. This study aimed to explore the comorbidity of ASD and other childhood onset neuropsychiatric disorders (COND) [attention-deficit/hyperactivity disorder (AD/HD) and tic disorders] in a group of severe eating disorder (ED) patients. Thirty female ED patients from a specialist hospital clinic were examined on measures tapping into COND and personality disorders. In our group of longstanding ED, 53% had at least one COND diagnosis; 23% had ASD, 17% had AD/HD, and 27% had a tic disorder. These preliminary data suggest that COND may be common in patients with severe ED and should be kept in mind when treating these patients.

  19. Mental disorders, brain disorders, neurodevelopmental disorders ...

    African Journals Online (AJOL)

    . Amongst DSM's most vocal 'insider' critics has been Thomas Insel, Director of the US National Institute of Mental Health. Insel has publicly criticised DSM's adherence to a symptom-based classification of mental disorder, and used the weight ...

  20. [Eating disorders].

    Science.gov (United States)

    Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa

    2015-02-01

    Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.

  1. Chicago Classification of Esophageal Motility Disorders: Lessons Learned

    NARCIS (Netherlands)

    Rohof, W. O. A.; Bredenoord, A. J.

    2017-01-01

    High-resolution manometry (HRM) is increasingly performed worldwide, to study esophageal motility. The Chicago classification is subsequently applied to interpret the manometric findings and facilitate a diagnosis of esophageal motility disorders. This review will discuss new insights regarding the

  2. Genetic Relationships Between Schizophrenia, Bipolar Disorder, and Schizoaffective Disorder

    Science.gov (United States)

    Cardno, Alastair G.

    2014-01-01

    There is substantial evidence for partial overlap of genetic influences on schizophrenia and bipolar disorder, with family, twin, and adoption studies showing a genetic correlation between the disorders of around 0.6. Results of genome-wide association studies are consistent with commonly occurring genetic risk variants, contributing to both the shared and nonshared aspects, while studies of large, rare chromosomal structural variants, particularly copy number variants, show a stronger influence on schizophrenia than bipolar disorder to date. Schizoaffective disorder has been less investigated but shows substantial familial overlap with both schizophrenia and bipolar disorder. A twin analysis is consistent with genetic influences on schizoaffective episodes being entirely shared with genetic influences on schizophrenic and manic episodes, while association studies suggest the possibility of some relatively specific genetic influences on broadly defined schizoaffective disorder, bipolar subtype. Further insights into genetic relationships between these disorders are expected as studies continue to increase in sample size and in technical and analytical sophistication, information on phenotypes beyond clinical diagnoses are increasingly incorporated, and approaches such as next-generation sequencing identify additional types of genetic risk variant. PMID:24567502

  3. The Neurocircuitry of Impaired Insight in Drug Addiction

    Science.gov (United States)

    Goldstein, Rita Z.; Craig, A. D. (Bud); Bechara, Antoine; Garavan, Hugh; Childress, Anna Rose; Paulus, Martin P.; Volkow, Nora D.

    2010-01-01

    More than 80% of addicted individuals fail to seek treatment, which might reflect impairments in recognition of severity of disorder. Considered by some as intentional deception, such `denial' might instead reflect dysfunction of brain networks subserving insight and selfawareness. Here we review the scant literature on insight in addiction and integrate this perspective with the role of: (i) the insula in interoception, self-awareness and drug craving; (ii) the anterior cingulate in behavioral monitoring and response selection (relevant to disadvantageous choices in addiction); (iii) the dorsal striatum in automatic habit formation; and (iv) drug related stimuli that predict emotional behavior in addicted individuals, even without conscious awareness. We discuss implications for clinical treatment including the design of interventions to improve insight into illness severity in addiction. PMID:19716751

  4. The Neurocircuitry of Impaired Insight in Drug Addiction

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, R.Z.; Craig, A.D.; Bechara, A.; Garavan, H.; Childress, A.R.; Paulus, M.P.; Volkow, N.D.

    2009-08-27

    More than 80% of addicted individuals fail to seek treatment, which might reflect impairments in recognition of severity of disorder. Considered by some as intentional deception, such 'denial' might instead reflect dysfunction of brain networks subserving insight and self-awareness. Here we review the scant literature on insight in addiction and integrate this perspective with the role of: (i) the insula in interoception, self-awareness and drug craving; (ii) the anterior cingulate in behavioral monitoring and response selection (relevant to disadvantageous choices in addiction); (iii) the dorsal striatum in automatic habit formation; and (iv) drug-related stimuli that predict emotional behavior in addicted individuals, even without conscious awareness. We discuss implications for clinical treatment including the design of interventions to improve insight into illness severity in addiction.

  5. Cephalic Disorders

    Science.gov (United States)

    ... information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). Patient Organizations Birth Defect Research for Children, Inc. 976 Lake Baldwin Lane Suite 104 Orlando ...

  6. Total Hip Replacement in Sickle Cell Disorder: A Preliminary report ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... as follows: periprosthetic fracture 1, superficial wound infection 1, pulmonary complication ... of intraoperative fractures as well as treatment of acetabular defects. A detailed ..... exposure and coagulation activation. Blood 2000 ...

  7. A PRELIMINARY JUPITER MODEL

    International Nuclear Information System (INIS)

    Hubbard, W. B.; Militzer, B.

    2016-01-01

    In anticipation of new observational results for Jupiter's axial moment of inertia and gravitational zonal harmonic coefficients from the forthcoming Juno orbiter, we present a number of preliminary Jupiter interior models. We combine results from ab initio computer simulations of hydrogen–helium mixtures, including immiscibility calculations, with a new nonperturbative calculation of Jupiter's zonal harmonic coefficients, to derive a self-consistent model for the planet's external gravity and moment of inertia. We assume helium rain modified the interior temperature and composition profiles. Our calculation predicts zonal harmonic values to which measurements can be compared. Although some models fit the observed (pre-Juno) second- and fourth-order zonal harmonics to within their error bars, our preferred reference model predicts a fourth-order zonal harmonic whose absolute value lies above the pre-Juno error bars. This model has a dense core of about 12 Earth masses and a hydrogen–helium-rich envelope with approximately three times solar metallicity

  8. A PRELIMINARY JUPITER MODEL

    Energy Technology Data Exchange (ETDEWEB)

    Hubbard, W. B. [Lunar and Planetary Laboratory, The University of Arizona, Tucson, AZ 85721 (United States); Militzer, B. [Department of Earth and Planetary Science, Department of Astronomy, University of California, Berkeley, CA 94720 (United States)

    2016-03-20

    In anticipation of new observational results for Jupiter's axial moment of inertia and gravitational zonal harmonic coefficients from the forthcoming Juno orbiter, we present a number of preliminary Jupiter interior models. We combine results from ab initio computer simulations of hydrogen–helium mixtures, including immiscibility calculations, with a new nonperturbative calculation of Jupiter's zonal harmonic coefficients, to derive a self-consistent model for the planet's external gravity and moment of inertia. We assume helium rain modified the interior temperature and composition profiles. Our calculation predicts zonal harmonic values to which measurements can be compared. Although some models fit the observed (pre-Juno) second- and fourth-order zonal harmonics to within their error bars, our preferred reference model predicts a fourth-order zonal harmonic whose absolute value lies above the pre-Juno error bars. This model has a dense core of about 12 Earth masses and a hydrogen–helium-rich envelope with approximately three times solar metallicity.

  9. The headache of temporomandibular disorders.

    Science.gov (United States)

    Virdee, J

    2018-03-01

    This article endeavours to revise the key guidance and evidence on temporomandibular disorders (TMD), with a particular focus on myofascial pain. It highlights the important role that primary care dental practitioners play in providing holistic care during the patient's journey to manage this painful condition. I hope to give an insight into my own personal experiences to highlight the challenges patients can face in seeking appropriate support.

  10. Muscle dysmorphia: current insights

    Directory of Open Access Journals (Sweden)

    Tod D

    2016-08-01

    Full Text Available David Tod1 Christian Edwards2 Ieuan Cranswick1 1School of Sport and Exercise Science, Faculty of Science, Liverpool John Moores University, Liverpool, Merseyside, 2Institute of Sport and Exercise Science, University of Worcester, Worcester, Worcestershire, UK Abstract: Since 1997, there has been increasing research focusing on muscle dysmorphia, a condition underpinned by people’s beliefs that they have insufficient muscularity, in both the Western and non-Western medical and scientific communities. Much of this empirical interest has surveyed nonclinical samples, and there is limited understanding of people with the condition beyond knowledge about their characteristics. Much of the existing knowledge about people with the condition is unsurprising and inherent in the definition of the disorder, such as dissatisfaction with muscularity and adherence to muscle-building activities. Only recently have investigators started to explore questions beyond these limited tautological findings that may give rise to substantial knowledge advances, such as the examination of masculine and feminine norms. There is limited understanding of additional topics such as etiology, prevalence, nosology, prognosis, and treatment. Further, the evidence is largely based on a small number of unstandardized case reports and descriptive studies (involving small samples, which are largely confined to Western (North American, British, and Australian males. Although much research has been undertaken since the term “muscle dysmorphia” entered the psychiatric lexicon in 1997, there remains tremendous scope for knowledge advancement. A primary task in the short term is for investigators to examine the extent to which the condition exists among well-defined populations to help determine the justification for research funding relative to other public health issues. A greater variety of research questions and designs may contribute to a broader and more robust knowledge base

  11. Muscle dysmorphia: current insights.

    Science.gov (United States)

    Tod, David; Edwards, Christian; Cranswick, Ieuan

    2016-01-01

    Since 1997, there has been increasing research focusing on muscle dysmorphia, a condition underpinned by people's beliefs that they have insufficient muscularity, in both the Western and non-Western medical and scientific communities. Much of this empirical interest has surveyed nonclinical samples, and there is limited understanding of people with the condition beyond knowledge about their characteristics. Much of the existing knowledge about people with the condition is unsurprising and inherent in the definition of the disorder, such as dissatisfaction with muscularity and adherence to muscle-building activities. Only recently have investigators started to explore questions beyond these limited tautological findings that may give rise to substantial knowledge advances, such as the examination of masculine and feminine norms. There is limited understanding of additional topics such as etiology, prevalence, nosology, prognosis, and treatment. Further, the evidence is largely based on a small number of unstandardized case reports and descriptive studies (involving small samples), which are largely confined to Western (North American, British, and Australian) males. Although much research has been undertaken since the term "muscle dysmorphia" entered the psychiatric lexicon in 1997, there remains tremendous scope for knowledge advancement. A primary task in the short term is for investigators to examine the extent to which the condition exists among well-defined populations to help determine the justification for research funding relative to other public health issues. A greater variety of research questions and designs may contribute to a broader and more robust knowledge base than currently exists. Future work will help clinicians assist a group of people whose quality of life and health are placed at risk by their muscular preoccupation.

  12. The “Insight Paradox” in Schizophrenia: Magnitude, Moderators and Mediators of the Association Between Insight and Depression

    Science.gov (United States)

    Belvederi Murri, Martino; Amore, Mario; Calcagno, Pietro; Respino, Matteo; Marozzi, Valentina; Masotti, Mattia; Bugliani, Michele; Innamorati, Marco; Pompili, Maurizio; Galderisi, Silvana; Maj, Mario

    2016-01-01

    The so-called “insight paradox” posits that among patients with schizophrenia higher levels of insight are associated with increased levels of depression. Although different studies examined this issue, only few took in account potential confounders or factors that could influence this association. In a sample of clinically stable patients with schizophrenia, insight and depression were evaluated using the Scale to assess Unawareness of Mental Disorder and the Calgary Depression Scale for Schizophrenia. Other rating scales were used to assess the severity of psychotic symptoms, extrapyramidal symptoms, hopelessness, internalized stigma, self-esteem, and service engagement. Regression models were used to estimate the magnitude of the association between insight and depression while accounting for the role of confounders. Putative psychological and sociodemographic factors that could act as mediators and moderators were examined using the PROCESS macro. By accounting for the role of confounding factors, the strength of the association between insight into symptoms and depression increased from 13% to 25% explained covariance. Patients with lower socioeconomic status (F = 8.5, P = .04), more severe illness (F = 4.8, P = .03) and lower levels of service engagement (F = 4.7, P = .03) displayed the strongest association between insight and depression. Lastly, hopelessness, internalized stigma and perceived discrimination acted as significant mediators. The relationship between insight and depression should be considered a well established phenomenon among patients with schizophrenia: it seems stronger than previously reported especially among patients with lower socioeconomic status, severe illness and poor engagement with services. These findings may have relevant implications for the promotion of insight among patients with schizophrenia. PMID:27069064

  13. Pickering safeguards: a preliminary analysis

    International Nuclear Information System (INIS)

    Todd, J.L.; Hodgkinson, J.G.

    1977-05-01

    A summary is presented of thoughts relative to a systems approach for implementing international safeguards. Included is a preliminary analysis of the Pickering Generating Station followed by a suggested safeguards system for the facility

  14. Cell emulation and preliminary results.

    Science.gov (United States)

    2016-07-01

    This report details preliminary results of the testing plan implemented by the Hawaii Natural Energy Institute to evaluate Electric Vehicle (EV) battery durability and reliability under electric utility grid operations. Commercial EV battery cells ar...

  15. Methodology and preliminary models for analyzing nuclear safeguards decisions

    International Nuclear Information System (INIS)

    1978-11-01

    This report describes a general analytical tool designed to assist the NRC in making nuclear safeguards decisions. The approach is based on decision analysis--a quantitative procedure for making decisions under uncertain conditions. The report: describes illustrative models that quantify the probability and consequences of diverted special nuclear material and the costs of safeguarding the material, demonstrates a methodology for using this information to set safeguards regulations (safeguards criteria), and summarizes insights gained in a very preliminary assessment of a hypothetical reprocessing plant

  16. Methodology and preliminary models for analyzing nuclear-safeguards decisions

    International Nuclear Information System (INIS)

    Judd, B.R.; Weissenberger, S.

    1978-11-01

    This report describes a general analytical tool designed with Lawrence Livermore Laboratory to assist the Nuclear Regulatory Commission in making nuclear safeguards decisions. The approach is based on decision analysis - a quantitative procedure for making decisions under uncertain conditions. The report: describes illustrative models that quantify the probability and consequences of diverted special nuclear material and the costs of safeguarding the material; demonstrates a methodology for using this information to set safeguards regulations (safeguards criteria); and summarizes insights gained in a very preliminary assessment of a hypothetical reprocessing plant

  17. Is good insight associated with depression among patients with schizophrenia? Systematic review and meta-analysis.

    Science.gov (United States)

    Belvederi Murri, Martino; Respino, Matteo; Innamorati, Marco; Cervetti, Alice; Calcagno, Pietro; Pompili, Maurizio; Lamis, Dorian A; Ghio, Lucio; Amore, Mario

    2015-03-01

    Among patients with schizophrenia, better insight may be associated with depression, but the findings on this issue are mixed. We examined the association between insight and depression in schizophrenia by conducting a systematic review and meta-analysis. The meta-analysis was based on 59 correlational studies and showed that global clinical insight was associated weakly, but significantly with depression (effect size r=0.14), as were the insight into the mental disorder (r=0.14), insight into symptoms (r=0.14), and symptoms' attributions (r=0.17). Conversely, neither insight into the social consequences of the disorder nor into the need for treatment was associated with symptoms of depression. Better cognitive insight was significantly associated with higher levels of depression. The exploratory meta-regression showed that methodological factors (e.g. the instrument used to assess depression and the phase of the illness) can significantly influence the magnitude of the association between insight and depression. Moreover, results from longitudinal studies suggest that the relation between insight and depression might be stronger than what is observed at the cross-sectional level. Finally, internalized stigma, illness perception, recovery attitudes, ruminative style, and premorbid adjustment seem to be relevant moderators and/or mediators of the association between insight and depression. In conclusion, literature indicates that among patients with schizophrenia, better insight is associated with higher levels of depressive symptoms. Thus, interventions aimed at promoting patients' insight should take into account the clinical implications of these findings. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Conduct disorders

    NARCIS (Netherlands)

    Buitelaar, J.K.; Smeets, K.C.; Herpers, P.; Scheepers, F.; Glennon, J.; Rommelse, N.N.J.

    2013-01-01

    Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic

  19. Personality disorders

    NARCIS (Netherlands)

    van den Bosch, L.M.C.; Verheul, R.; Verster, J.C.; Brady, K.; Galanter, M.; Conrod, P.

    2012-01-01

    Subject of this chapter is the often found combination of personality disorders and ­substance abuse disorders. The serious nature of this comorbidity is shown through the discussion of prevalence and epidemiological data. Literature shows that the comorbidity, hampering the diagnostic process, is

  20. Parental insightfulness: retrospect and prospect.

    Science.gov (United States)

    Koren-Karie, Nina; Oppenheim, David

    2018-06-01

    We open this introductory paper to the special issue with the theoretical and clinical roots of the insightfulness concept. Next, the Insightfulness Assessment (IA) is presented, followed by a review of key empirical findings supporting the IA. The central points in the papers in this special issue are reviewed next. These include the use of the IA with parents of children ranging in age from infancy to adolescence, its applicability outside the parent-child relationship (e.g. insightfulness toward a close friend), its use with high-risk mothers, and the usefulness of insightfulness both as a continuous and a categorical measure. The clinical applications of the IA are discussed, and we close with future directions for IA research.

  1. Personality disorder

    DEFF Research Database (Denmark)

    Tyrer, Peter; Mulder, Roger; Crawford, Mike

    2010-01-01

    and to society, and interferes, usually negatively, with progress in the treatment of other mental disorders. We now have evidence that personality disorder, as currently classified, affects around 6% of the world population, and the differences between countries show no consistent variation. We are also getting......Personality disorder is now being accepted as an important condition in mainstream psychiatry across the world. Although it often remains unrecognized in ordinary practice, research studies have shown it is common, creates considerable morbidity, is associated with high costs to services...... increasing evidence that some treatments, mainly psychological, are of value in this group of disorders. What is now needed is a new classification that is of greater value to clinicians, and the WPA Section on Personality Disorders is currently undertaking this task....

  2. Gambling disorders.

    Science.gov (United States)

    Hodgins, David C; Stea, Jonathan N; Grant, Jon E

    2011-11-26

    Gambling disorders, including pathological gambling and problem gambling, have received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. This Seminar reviews prevalence, causes and associated features, screening and diagnosis, and treatment approaches. Gambling disorders affect 0·2-5·3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favourably evaluated, such as cognitive behavioural and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Franchise Business Model: Theoretical Insights

    OpenAIRE

    Levickaitė, Rasa; Reimeris, Ramojus

    2010-01-01

    The article is based on literature review, theoretical insights, and deals with the topic of franchise business model. The objective of the paper is to analyse peculiarities of franchise business model and its developing conditions in Lithuania. The aim of the paper is to make an overview on franchise business model and its environment in Lithuanian business context. The overview is based on international and local theoretical insights. In terms of practical meaning, this article should be re...

  4. Autism spectrum disorder - childhood disintegrative disorder

    Science.gov (United States)

    ... part of the larger developmental disorder category of autism spectrum disorder . ... American Psychiatric Association. Autism spectrum disorder. ... VA: American Psychiatric Publishing: 2013;50-59. Raviola GJ, ...

  5. Acceptability and feasibility of self-help Cognitive Remediation Therapy for anorexia nervosa delivered in collaboration with carers: a qualitative preliminary evaluation study.

    Science.gov (United States)

    Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2015-02-28

    Anorexia nervosa (AN) is an eating disorder without a recommended first-line treatment. Cognitive Remediation Therapy (CRT) is showing great promise in helping patients reduce cognitive inflexibility and excessive detail focus, thinking styles that could make engaging in psychological therapies difficult. CRT has shown to be effective, feasible and acceptable in both individual and group formats, and positive qualitative data has been gathered from both service users and clinicians. The aim of the current study was to assess the use of CRT as a self-help treatment for individuals with AN delivered in collaboration with carers. Six families underwent a six-week self-help CRT intervention. Feedback was gathered from qualitative interviews and analysed using thematic analysis. Neuropsychological outcomes were also collected. Participant feedback regarding the intervention was generally positive, with participants describing a number of benefits such as it creating a space for families to spend time together outside of the eating disorder, acting as a 'gateway' for more emotional work and helping participants to gain insight into their cognitive profiles. These preliminary findings suggest that self-help CRT delivered in collaboration with carers is an acceptable form of treatment, and adds to the growing literature supporting CRT for AN. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. [Dissociative disorders and affective disorders].

    Science.gov (United States)

    Montant, J; Adida, M; Belzeaux, R; Cermolacce, M; Pringuey, D; Da Fonseca, D; Azorin, J-M

    2014-12-01

    The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  7. Tic disorders: some key issues for DSM-V.

    Science.gov (United States)

    Walkup, John T; Ferrão, Ygor; Leckman, James F; Stein, Dan J; Singer, Harvey

    2010-06-01

    This study provides a focused review of issues that are relevant to the nosology of the tic disorders and presents preliminary recommendations to be considered for DSM-V. The recommended changes are designed to clarify and simplify the diagnostic criteria, reduce the use of the residual category, tic disorder not otherwise specified, and are not intended to alter substantially clinical practice or the continuity of past and future research. Specific recommendations include: (1) a more precise definition of motor and vocal tics; (2) simplification of the duration criterion for the tic disorders; (3) revising the term "transient tic disorder" for those with tic symptoms of less than 12-month duration; (4) establishing new tic disorder categories for those with substance induced tic disorder and tic disorder due to a general medical condition; and (5) including a motor tic only and vocal tic only specifier for the chronic motor or vocal tic disorder category. (c) 2010 Wiley-Liss, Inc.

  8. Visual field examination in children with brain disorders

    NARCIS (Netherlands)

    Koenraads, Y

    2016-01-01

    The aim of this thesis is to gain more insight in the diagnostic and prognostic implications of visual field (VF) examination in children with brain disorders. Several aspects of VF examination in children with brain disorders were evaluated: All VF examinations that were performed with the

  9. Bipolar Disorder: not only in the Brain - immunological aspects

    NARCIS (Netherlands)

    E.M. Knijff (Esther)

    2006-01-01

    textabstractThe main objective of this thesis was to obtain more insight in the role of the immune system in the pathogenesis of bipolar disorder by investigating various aberrancies in the immune system of patients with bipolar disorder. In Chapter 1 some general concepts, important for the

  10. Conduct disorder

    Science.gov (United States)

    ... develop problems with drug abuse and the law. Depression and bipolar disorder may develop in the teen years and early adulthood. Suicide and violence toward others are also possible complications.

  11. Sleep Disorders

    Science.gov (United States)

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  12. Eating Disorders

    Science.gov (United States)

    ... to control them. Avoidant/Restrictive Food Intake Disorder (ARFID) ARFID is a new term that some people think ... eating issues can also cause it. People with ARFID don't have anorexia or bulimia, but they ...

  13. Neurocutaneous Disorders.

    Science.gov (United States)

    Rosser, Tena

    2018-02-01

    This article presents an up-to-date summary of the genetic etiology, diagnostic criteria, clinical features, and current management recommendations for the most common neurocutaneous disorders encountered in clinical adult and pediatric neurology practices. The phakomatoses are a phenotypically and genetically diverse group of multisystem disorders that primarily affect the skin and central nervous system. A greater understanding of the genetic and biological underpinnings of numerous neurocutaneous disorders has led to better clinical characterization, more refined diagnostic criteria, and improved treatments in neurofibromatosis type 1, Legius syndrome, neurofibromatosis type 2, Noonan syndrome with multiple lentigines, tuberous sclerosis complex, Sturge-Weber syndrome, and incontinentia pigmenti. Neurologists require a basic knowledge of and familiarity with a wide variety of neurocutaneous disorders because of the frequent involvement of the central and peripheral nervous systems. A simple routine skin examination can often open a broad differential diagnosis and lead to improved patient care.

  14. Factitious Disorder

    Science.gov (United States)

    ... support their claims. Factitious disorder signs and symptoms may include: Clever and convincing medical or psychological problems Extensive knowledge of medical terms and diseases Vague or inconsistent symptoms Conditions that get worse for no apparent ...

  15. Neuromuscular Disorders

    Science.gov (United States)

    ... lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include Amyotrophic lateral sclerosis Multiple sclerosis Myasthenia ...

  16. Conduct Disorder

    Science.gov (United States)

    ... objections runs away from home often truant from school Children who exhibit these behaviors should receive a comprehensive evaluation by an experience mental health professional. Many children with a conduct disorder may ...

  17. Amnestic Disorders

    NARCIS (Netherlands)

    Kessels, R.P.C.; Savage, G.; Cautin, R.L.; Lilienfeld, S.O.

    2015-01-01

    Amnestic disorders may involve deficits in the encoding or storage of information in memory, or in retrieval of information from memory. Etiologies vary and include traumatic brain injury, neurodegenerative disease, and psychiatric illness. Different forms of amnesia can be distinguished:

  18. Sleep Disorders

    DEFF Research Database (Denmark)

    Rahbek Kornum, Birgitte; Mignot, Emmanuel

    2014-01-01

    mediates circadian regulation of sleep. Misalignment with the rhythm of the sun results in circadian disorders and jet lag. The molecular basis of homeostatic sleep regulation is mostly unknown. A network of mutually inhibitory brain nuclei regulates sleep states and sleep-wake transitions. Abnormalities...... in these networks create sleep disorders, including rapid eye movement sleep behavior disorder, sleep walking, and narcolepsy. Physiological changes associated with sleep can be imbalanced, resulting in excess movements such as periodic leg movements during sleep or abnormal breathing in obstructive sleep apneas....... As every organ in the body is affected by sleep directly or indirectly, sleep and sleep-associated disorders are frequent and only now starting to be understood....

  19. TMJ Disorders

    Science.gov (United States)

    ... Aching pain in and around your ear Difficulty chewing or pain while chewing Aching facial pain Locking of the joint, making ... disorder. When to see a doctor Seek medical attention if you have persistent pain or tenderness in ...

  20. Autoimmune disorders

    Science.gov (United States)

    ... exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...