Pharmacotherapy of obesity and eating disorders.

Difficulties associated with eating behavior, existing on a broad continuum from uncomplicated overeating to psychopathologically disordered eating, is a growing area of concern within the medical and mental health communities. Psychologists are often called upon to conduct diagnostic assessments in order to identify issues or disorders that may require attention and provide psychotherapeutic interventions ranging from supportive to more intensive therapy. Over the past several years, there have been increased efforts to develop safe and efficacious pharmacologic treatments for obesity and eating disorders. This article provides psychologists with a review of the most currently used pharmacologic interventions for eating dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical correlates of anhedonia and perceptual aberration in first-episode patients with schizophrenia and affective disorder.

Examined the association between scales measuring physical anhedonia, social anhedonia, and perceptual aberration and premorbid functioning, clinical state, and current level of adjustment in 91 psychotic Ss. The patients were examined at the onset of their 1st psychotic episode and again 18 mo later. For patients with schizophrenia, anhedonia was significantly related to premorbid functioning. No association was found between the scales and clinical state or level of adjustment at intake or follow-up. In affective disorder patients, no correlation was found between premorbid functioning (a stable characteristic) and scale scores, but moderately large correlations emerged between the scales and clinical state and level of adjustment at both assessment times. These results suggest that schizophrenic and affective disorder patients endorse items on these scales for different reasons. The authors hypothesize that for patients with schizophrenia the scales assess enduring personality characteristics, whereas for the affective disordered patients they assess clinical condition at the time of testing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associative disturbance in schizophrenia, schizoaffective disorders, and major affective disorders: Comparisons between hospitalization and 1-year follow-up.

Word-association performance of 71 Research Diagnostic Criteria-diagnosed schizophrenic, schizoaffective, and affective disorder patients was assessed shortly after hospital admission to evaluate the diagnostic specificity of associative disturbance. The same Ss were assessed again 1 yr after discharge to investigate the longitudinal course of word-association behavior. Data regarding rehospitalization were included in the analyses of 4 primary word-association indices. Results indicate that thought disorder was not distinctively schizophrenic and that associative thought disorder was more characteristically associated with rehospitalization for affective disorder patients than for other diagnostic groups. Arousal and cognitive control mechanisms are discussed. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy of first-episode schizophrenia

BACKGROUND: A growing interest in first-episode schizophrenia reflects the belief that this line of investigation will lead to further developments regarding schizophrenia's aetiology, course and outcome. METHOD: Evidence from more recent clinical trials involving first-episode schizophrenia is integrated with neuroimaging data, specifically positron emission tomography, to provide direction regarding pharmacotherapy. RESULTS: Individuals with a first episode of schizophrenia appear particularly responsive to pharmacotherapy, as well as quite sensitive to side-effects. At the same time, current clinical and receptor-binding data support the efficacy of low-dose neuroleptic treatment. CONCLUSIONS: Early and effective treatment of schizophrenia has been associated with better long-term outcome. Low-dose neuroleptic therapy is an effective treatment strategy and the diminished risk of side-effects with this approach may further enhance compliance and outcome.     

An activity-withdrawal distinction in schizophrenia: Behavioral, clinical, brain damage, and neurophysiological correlates.

Although P. H. Venables introduced an activity-withdrawal distinction in schizophrenia in 1957, the activity variable has been virtually neglected in the research literature on this disorder. This is clearly unwarranted because, as this paper illustrates, this distinction is potentially related to a number of behavioral, clinical, brain damage, and neurophysiological variables. In addition to the presentation of new data, these variables are discussed in relation to the activity-withdrawal distinction, and future research is proposed. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual disorders: demographic and diagnostic profile during one year of a multidisciplinary project

Taking into consideration a study published 10 years ago on sexual disturbances of students at the University of S?o Paulo, the importance of the subject is discussed, along with the creation in 1993 of the Sexuality Project at the university hospital of the University of S?o Paulo School of Medicine. In its first year, this multidisciplinary project attended 140 patients with sexual dysfunctions (associated or not to other clinical manifestations); the majority were younger than 60 years-old, and 80 percent were male.     

Clinical judgment and affective disorders.

Addresses 3 limitations of previous work on counselor clinical judgment by the 1st author et al (see record 1983-11141-001) and R. F. Haase et al (see record 1983-26503-001). Results of the study of 20 practicing counselors suggest that the judgment process used by experienced counselors to make diagnoses of affective disorders differs depending on the type of diagnostic judgment and that attributions may play a role in at least certain types of judgments. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Poststroke bipolar affective disorder: clinical subtypes, concurrent movement disorders, and anatomical correlates

The authors describe 9 patients with bipolar affective disorder associated with cerebrovascular lesions. Eight had negative family histories of affective disorders and late age at onset (after age 40) of manic-depressive symptoms. Only one, with positive family history of affective disorders, developed mood swings before age 40. Clinical subtypes of bipolar disorder and patterns of affective cycling in these stroke patients resembled those previously reported in functional bipolar disorder. Five patients had concurrent hyperkinetic movement disorders, and one depressed patient presented with unilateral left-sided parkinsonism that disappeared during a manic switch. In most patients, bipolar affective disorder was associated with right hemisphere lesions that involved subcortical and midline structures. Findings suggest that damage to frontal-basal ganglia-thalamocortical circuits by subcortical vascular lesions may simultaneously provoke disorders of movement and mood regulation.     

Arousal contributions to affective priming: Electrophysiological correlates.

Current models of affective processing postulate that not only valence but also the arousal dimension characterizes the emotional experience. However, up-to-date research on affective priming has mainly focused on the contributions of valence congruency to priming. In this study, the authors explored the possible influence of arousal in priming processes. For this purpose, event-related potentials and reaction times were measured in response to high- and low-arousing positive targets that were either congruent or incongruent in arousal with a prime word. Priming arousal did not influence reaction times. By contrast, the processing of high-arousing targets was facilitated by a previous exposure to a congruent prime, as reflected by the reduction in the amplitude of a late positive component around 500 ms that has been thought to reflect attentional and memory processes. These results diverge from the findings of previous studies that primed valence and suggest a differential contribution of arousal and valence to affective priming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy of acid-peptic disorders

In the past two decades, there have been tremendous changes in the understanding and therapy of acid-peptic diseases. Currently there are many new and effective approaches to the treatment of dyspeptic symptoms and the ulcerative and erosive diseases of the upper gastrointestinal tract. Application of an appropriate therapeutic strategy requires understanding of the pathophysiology of the disease process as well as the pharmacology of the available medications. In general, medications to neutralize gastric acid or suppress acid secretion are selected relative to the severity of the acid-mediated injury. Antacids are ideal for suppression of sporadic symptoms. H2-receptor antagonists are useful for the treatment of dyspepsia or uncomplicated ulcers. For the most severe injuries, proton pump inhibitors provide both relief of symptoms and healing of damaged mucosa.     

Neutralization of affective concepts in schizophrenia.

Reports experimental data from schizophrenic and nonpsychotic Ss which provide reasonably strong support for the hypothesis that invalidation of affective judgments of schizophrenics leads them to neutralize their judgments. Data suggest that neutralization may be an important phenomenon in schizophrenic conceptual processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Employment discrimination: Authority figures' demographic preferences and followers' affective organizational commitment.

The authors used theories of organizational commitment and obedience to authority to explain employment discrimination. In Study 1, employees participated in an experimental simulation of their work. An organizational authority's demographic preferences led to employment discrimination. As expected, affective organizational commitment moderated this effect, such that it was stronger for more committed employees. In Study 2, another sample of employees completed a survey that included an employment discrimination scenario. A model of linkages from affective organizational commitment to submissiveness to organizational authorities to employment discrimination fit the data well, after controlling for prejudicial attitudes and authoritarianism. Submissiveness to organizational authorities mediated the relationship between affective organizational commitment and employment discrimination. The authors discuss the importance of studying employment discrimination as an organizational and not just an intergroup phenomenon. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental pathways to schizophrenia: Behavioral stereotypes.

This study examined childhood behavior problems in schizophrenic patients and their healthy siblings. Childhood Behavior Checklist (T. Achenbach, 1991) ratings were obtained from retrospective maternal reports, for 4 age periods: birth to 4 years, 4 to 8 years, 8 to 12 years, and 12 to 16 years. The results indicated that the patients had a variety of childhood behavior problems when compared to their siblings and that the various types of problems differed in their developmental course. Cluster analysis was conducted on the childhood behavior ratings for the schizophrenic patients, and 2 subgroups emerged. Cluster I showed more pronounced behavioral problems than Cluster II, and some of these problems were apparent in early childhood and increased with age. Cluster I also demonstrated greater neuromotor abnormalities in childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Premorbid adjustment and affective expression in schizophrenia.

Randomly selected 2 samples composed of 25 process and 25 reactive schizophrenics. There were no significant differences among the groups either in mean age or education. Mmpi deviation scores were obtained for each s by subtracting s's mean clinical scale score from each of the 9 mmpi clinical scales. Reactive ss had significantly (p     

Multidimensional relations between intellectual abilities and demographic variables.

The standardization sample of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was the basis for an analysis of the WAIS-R subscales in relation to demographic variables. Canonical correlation with orthogonal rotation of composite structural components was performed in order to determine interrelations between both sets of variables, thereby providing an integrated approach to previous research concerning subtest patterns of ability. A 1st rotated factor indicated a general factor with high loadings on all 11 subscales, education, race, and occupation. This factor represented crystallized intelligence or ability (Cattell, 1943). A 2nd rotated factor indicated a performance factor with loadings on the 5 performance subscales, age, and single marital status. This factor represented fluid intelligence or ability. A 3rd rotated factor revealed a sex-specific or manual dexterity factor for males on the Block Design subtest and being in a skilled worker occupation. The relatively strong relations support the original purposes of the intelligence movement in identifying people likely to be successful in academic pursuits, but the implications for equality of educational opportunity may have been ignored or masked by previous univariate methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental expressed emotion and affective style in an adolescent sample at risk for schizophrenia spectrum disorders.

Investigated the correspondence between interview-assessed parental emotional attitudes toward a particular offspring (expressed emotion; EE) and parental affective behavior manifested in direct family interactions for 52 14–19 yr old disturbed but nonpsychotic adolescents. Individual parents who expressed an excessive number of critical comments during the interview (high EE) manifested significantly more mild and harsh criticisms in direct interactions with their offspring than did low-EE parents. A more complex relationship emerged between attitudes and behavior when both parents' emotional attitudes were considered simultaneously. When both parents were high EE, they expressed high levels of mild and harsh criticisms in direct interactions with their offspring. Parental affective behavior in families with only 1 high-EE parent was characterized by high levels of mild criticisms but low levels of harsh criticisms. When both parents were low EE, they manifested few mild or harsh criticisms in direct interactions. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pretreatment plasma homovanillic acid in schizophrenia and schizoaffective disorder: the influence of demographic variables and the inpatient drug-free period

BACKGROUND: The relationship between plasma homovanillic acid (pHVA) and schizophrenic symptoms has not been conclusively determined. We reexamine pHVA levels in a new sample of patients with emphasis on demographic variables and the drug-free period. METHODS: Plasma HVA levels were studied in 54 schizophrenic and schizoaffective-disordered, drug-free inpatients suffering from a psychotic exacerbation. RESULTS: A significant correlation was observed between pHVA levels and the number of inpatient drug-free days in the total sample, as well as the schizophrenic patient subsample. Further, pHVA was significantly and positively correlated with the duration of illness in the schizophrenic patient subsample. Plasma HVA correlations with behavior, as measured by Brief Psychiatric Rating Scale factors (anxiety/depression and hostility/suspiciousness), emerged only when considering schizophrenic patients drug-free for more than 2 weeks. No correlation was found between pHVA and the age of illness onset or the duration of the delay of treatment of the first psychotic episode. CONCLUSIONS: The effects of antipsychotic withdrawal on levels of pHVA in clinical populations may have to be examined and controlled for in future studies attempting to study the relationship between this metabolite and behavior in acutely ill, drug-free schizophrenic patients.     

Pathways linking affective disturbances and physical disorders.

Comorbidity of psychological and physical disorders is substantial. This article presents a broad theoretical framework for identifying factors that contribute to and maintain comorbid conditions. The authors propose heuristic models of how co-occurrences of psychological and physical disorders are developed and maintained. The models specify biological, behavioral, cognitive, and social pathways that may account for comorbidity. Although the authors' discussion of psychological disorders is limited to the role of affective disturbances (subclinical negative moods as well as mood and affective disorders), the pathways they identify are thought to contribute to co-occurrences of other psychological disorders and physical disease as well. The authors emphasize that pathways linking comorbid states are bi-directional and that operative pathways differ depending on the specific affective response, illness behavior, disease, or disease stage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive event-related potential correlates of schizophrenia.

Reviews findings relating schizophrenia to 4 event-related brain voltage potential components: contingent negative variation (CNV), N100, P300, and slow wave. Research indicates that schizophrenics manifest several cognitive event-related potential (ERP) abnormalities relative to control Ss, including a diminished CNV in warned reaction time (RT) paradigms during the warning stimulus–imperative stimulus interval. This CNV continues beyond presentation of the imperative stimulus as the postimperative negative variation (PINV). CNV attenuation may reflect a state marker of psychosis in acute schizophrenics, but it may serve as a trait marker regardless of current symptoms in more chronic patients. In contrast, the PINV may be more of a state marker for both acute and chronic patients. There is a pattern of P100–N100 reducing in acute schizophrenics that is not seen in chronic and paranoid patients, as well as evidence of an attenuated enhancement of N100 to stimuli presented in an attended channel, especially at slower event rates. A diminished late positive complex apparently due more to a diminished P300 than a diminished slow wave has been observed in schizophrenics, which may to a degree reflect a trait marker of high risk for schizophrenia as well as a residual deficit state that often remains following the remission of positive symptoms. With the possible exception of the PINV elicited in standard CNV paradigms, these ERP abnormalities do not appear to be specific to schizophrenia, as they are also found in association with a variety of other disorders. (5 p ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychophysiological correlates of responsiveness in schizophrenia.

Measured responsiveness under stress through music preferences for 11 male and 9 female schizophrenics receiving no antipsychotic medication. These Ss were compared with a control group of 7 male and 13 female hospital staff or volunteers. Results indicate that higher schizophrenic responsiveness was related to lower skin conductance, fewer body movements, greater diastolic blood pressure decrease, better word recall, and shorter periods of institutionalization. Normal controls did not differ significantly in music preferences but were lower in all physiological measures. The finding that sweat gland activity, muscle tension, and diastolic blood pressure changes were related to stress in these acute schizophrenics paralleled the findings of A. F. Ax, et al (1969) with chronic schizophrenics. The interpretation that responsiveness is related to ability to cope with stress in schizophrenia is supported by results of the current study. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)