Obsessive-compulsive disorder and ventromedial frontal lesions: clinical and neuropsychological findings

Using whole cell recording techniques, we distinguished immature from mature stages of development in auditory thalamic neurons of rats at ages P5 to P21. We compared voltage responses to injected currents and firing patterns of neurons in ventral partition of medial geniculate body (MGBv) in slices. Resting potential, input resistance and membrane time constant diminished to mature values between P5 and P14. Responses of young neurons to hyperpolarizing pulses showed delayed inward rectification; after P13, this was obscured by a rapid onset of another inward rectifier. All neurons possessed tetrodotoxin (TTX)-sensitive, depolarization-activated rectification, implying persistent Na+-current involvement. Despite a slightly higher voltage threshold for spiking, the current threshold was lower in younger neurons. Young neurons fired a short latency spike with afterhyperpolarization whereas older neurons exhibited a slow ramplike depolarization before tonic firing. Large currents caused continuous firing in all neurons. Before day P13, a high threshold Ca2+ spike (HTS) often was appended to action potentials. The low threshold Ca2+-spike (LTS) was too small in amplitude to evoke action potentials before P11 but produced a single spike at P12 and P13 and burst firing with HTS after P13. MGBv neurons have mature properties after P14, relevant for reactions to sound and the oscillations of slow-wave sleep.     

Antisocial personality disorder and alcohol-induced aggression

This study compared the effects of alcohol on aggressive responding between subjects with antisocial personality disorder (ASPD) and subjects without ASPD. Eighteen alcohol drinking subjects (10 subjects without ASPD and 8 subjects with ASPD) underwent testing on a laboratory measure of aggression, the Point Subtraction Aggression Paradigm, after consumption of placebo and three doses of alcohol (0.25 g/kg, 0.5 g/kg, and 1.0 g/kg). There was a significant difference in the effect of alcohol on aggressive responding on the Point Subtraction Aggression Paradigm between subjects with ASPD and subjects without ASPD. Subjects with ASPD had a greater increase in aggressive responding after alcohol, compared with non-ASPD subjects. There was no difference between the two groups in the effect of alcohol on monetary-reinforced responding.     

Antisocial personality disorder, conduct disorder, and substance abuse in schizophrenia.

The validity of subtypes based on antisocial personality disorder (APD) or childhood conduct disorder without adult APD (CD only) in patients with schizophrenia (or schizoaffective disorder) and a substance use disorder (abuse or dependence) was examined. APD patients scored lower on personality measures related to socialization and higher on antisocial bebavior, psychopathy, and aggression. APD patients also reported higher rates of aggression and legal problems. APD, and to a lesser extent CD only, was associated with more severe psychiatric symptoms, an earlier age of onset of substance abuse, more severe symptoms of substance abuse, and a stronger family history of substance abuse and psychiatric hospitalization. The findings suggest that schizophrenia patients with APD represent a high-risk subgroup vulnerable to more severe substance abuse, psychiatric impairment, aggression, and legal problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antisocial personality disorder in abused and neglected children grown up

OBJECTIVE: the authors' goal in this study was to examine the extent to which having been abused and/or neglected in childhood raises a person's risk for having an adult DSM-III-R diagnosis of antisocial personality disorder. METHOD: Children who had experienced substantiated child abuse and/or neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age, race, sex, and approximate family social class with a group of nonabused and nonneglected children and followed prospectively into young adulthood. Subjects were located and participated in a 2-hour interview consisting of a series of structured and semistructured questions, rating scales, and a psychiatric assessment using the National Institute of Mental Health Diagnostic Interview Schedule. Interviews were completed with 699 young adult subjects (416 abused and/or neglected and 283 comparison subjects). RESULTS: Childhood victimization was a significant predictor of the number of lifetime symptoms of antisocial personality disorder and of a diagnosis of antisocial personality disorder, despite the fact that controls for demographic characteristics and arrest history were introduced. CONCLUSIONS: These findings suggest the importance of inquiring about a patient's childhood history of abuse and/or neglect when antisocial symptoms are evident. In addition to speculation about a possible saturation model for the consequences of childhood victimization, these findings also reinforce a multiple causation model of antisocial personality disorder.     

Borderline personality traits and disorder: Predicting prospective patient functioning.

Objective: Decisions about the composition of personality assessment in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–V) will be heavily influenced by the clinical utility of candidate constructs. In this study, we addressed 1 aspect of clinical utility by testing the incremental validity of 5-factor model (FFM) personality traits and borderline personality disorder (BPD) symptoms for predicting prospective patient functioning. Method: FFM personality traits and BPD features were correlated with one another and predicted 2-, 4-, 6-, 8-, and 10-year psychosocial functioning scores for 362 patients with personality disorders. Results: Traits and symptom domains related significantly and pervasively to one another and to prospective functioning. FFM extraversion and agreeableness tended to be most incrementally predictive of psychosocial functioning across all intervals; cognitive and impulse action features of BPD features incremented FFM traits in some models. Conclusions: These data suggest that BPD symptoms and personality traits are important long-term indicators of clinical functioning that both overlap with and increment one another in clinical predictions. Results support the integration of personality traits and disorders in DSM–V. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender, alcoholism, and neuropsychological functioning.

35 female and 25 male alcoholics (mean age 45) performed significantly more slowly than similar numbers of age-matched nonalcoholic controls on the Tactual Performance Test (TPT), especially with the left hand. Alcoholism effects were not significant for TPT Memory or Location. Women recalled significantly more shapes but correctly located fewer of those remembered than did men. Results suggest that (a) alcoholism effects on tactual–spatial performance are similar in men and women, (b) right hemisphere functions or less well-practiced skills may be selectively vulnerable to alcoholism, and (c) sex differences exist in tactual memory and spatial location abilities. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention deficit disorder and neuropsychological functioning in children with Tourette's syndrome.

Neuropsychological deficits in Tourette's syndrome (TS) may result from comorbid psychiatric disorders. This study compared the neuropsychological performance of TS children with and without attention deficit disorder (ADD). Participants were 82 children between 6 and 18 yrs of age with TS, 36 of whom had ADD. ADD children did not differ from non-ADD children in age or in onset or duration of TS but did display more severe complex tics and obsessive-compulsive symptoms. After statistical control for these characteristics, ADD children demonstrated significant deficits in various elements of attention, including encoding, sustaining, and focusing/ executing, and in academic achievement. They did not differ in IQ, non-attentional cognitive skills, or sensorimotor functions. The comorbid psychiatric disorders associated with TS yield distinct patterns of neuropsychological functioning that may reflect overlapping neuroanatomic substrates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verb generation in patients with focal frontal lesions: a neuropsychological test of neuroimaging findings

What are the neural bases of semantic memory? Traditional beliefs that the temporal lobes subserve the retrieval of semantic knowledge, arising from lesion studies, have been recently called into question by functional neuroimaging studies finding correlations between semantic retrieval and activity in left prefrontal cortex. Has neuroimaging taught us something new about the neural bases of cognition that older methods could not reveal or has it merely identified brain activity that is correlated with but not causally related to the process of semantic retrieval? We examined the ability of patients with focal frontal lesions to perform a task commonly used in neuroimaging experiments, the generation of semantically appropriate action words for concrete nouns, and found evidence of the necessity of the left inferior frontal gyrus for certain components of the verb generation task. Notably, these components did not include semantic retrieval per se.     

Sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder.

Objective: To investigate sex differences in neurocognition and social functioning in schizophrenia and bipolar disorder and the possible role of sex as a moderator of this relationship. Method: Participants with schizophrenia (60 women/94 men), bipolar I disorder (55 women/51 men), and healthy controls (158 women/182 men) were assessed with an extensive neuropsychological test battery and a social functioning questionnaire. Results: We found significant main effects of sex for neuropsychological tests (p     

Resting frontal EEG asymmetry as an endophenotype for depression risk: Sex-specific patterns of frontal brain asymmetry.

Resting frontal electroencephalographic (EEG) asymmetry has been hypothesized as a marker of risk for major depressive disorder (MDD), but the extant literature is based predominately on female samples. Resting frontal asymmetry was assessed on 4 occasions within a 2-week period in 306 individuals aged 18–34 (31% male) with (n = 143) and without (n = 163) lifetime MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994). Lifetime MDD was linked to relatively less left frontal activity for both sexes using a current source density (CSD) reference, findings that were not accounted for solely by current MDD status or current depression severity, suggesting that CSD-referenced EEG asymmetry is a possible endophenotype for depression. In contrast, results for average and linked mastoid references were less consistent but demonstrated a link between less left frontal activity and current depression severity in women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, episodic memory feeling-of-knowing, and frontal functioning.

Groups of normal old and young adults made episodic memory feeling-of-knowing (FOK) judgments and took 2 types of episodic memory tests (cued recall and recognition). Neuropsychological tests of executive and memory functions thought to respectively involve the frontal and medial temporal structures were also administered. Age differences were observed on the episodic memory measures and on all neuropsychological tests. Compared with young adults, older adults performed at chance level on FOK accuracy judgments. Partial correlations indicated that a composite measure of frontal functioning and FOK accuracy were closely related. Hierarchical regression analyses showed that the composite frontal functioning score accounted for a large proportion of the age-related variance in FOK accuracy. This finding supports the idea that the age-related decline in episodic memory FOK accuracy is mainly the result of executive or frontal limitations associated with aging. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term outcome from childhood traumatic brain injury: Intellectual ability, personality, and quality of life.

Objective: Only a handful of studies have attempted to explore very long-term outcomes from childhood traumatic brain injury (TBI). These studies have generally failed to fully consider the impact of injury severity or employ measures sensitive to the survivor's day-to-day function. This study examined outcomes in adulthood, with a focus on functional abilities including education, employment, and quality of life (QOL), and employed predictors including injury severity, age at injury, socioeconomic factors, intelligence, and personality. Method: The study was retrospective and cross-sectional and included 50 adult survivors of child TBI (31 males), aged 19–30 years at evaluation (M = 24.2, SD = 3.6), with injury on average 13.3 years prior to evaluation. Participants were divided according to injury severity—mild (n = 20), moderate (n = 12), and severe (n = 18)—completed an intellectual evaluation and questionnaires regarding educational and employment status, personality, and quality of life. Results: Intellectual and personality measures indicated good outcomes, with mean scores for all groups in the average range and few severity-based findings. In contrast, those with more severe TBI were more likely to have educational and employment problems. QOL was significantly reduced in the context of severe insult, with lower IQ and personality factors most predictive of outcome in this domain. Mild and moderate TBI were generally more benign. Conclusions: Findings suggest that, while TBI is a lifelong problem, its impact is most dramatic in the domain of QOL, where a complex interaction occurs between injury factors, cognition, and personality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.

This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post–cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Features of borderline personality disorder, perceived childhood emotional invalidation, and dysfunction within current romantic relationships.

The mechanisms through which current romantic relationship dysfunction develops in individuals with borderline personality disorder (BPD) symptoms are still unclear. One possible pathway may be childhood experiences of emotional invalidation by parents, which may result in the development of poor social problem-solving skills or cognitive responses such as splitting, which impair current romantic relationships. This study examines the relationship between features of BPD and current romantic relationship dysfunction, and demonstrates that perceived emotional invalidation by parents during childhood mediates the relationship between BPD features and current romantic relationship dysfunction. Structural equations modeling was used to test the hypothesized model in 758 young adults in an ethnically diverse community sample. The proposed model fit the data well; perceived childhood emotional invalidation partially mediated the relationship between features of BPD and romantic relationship dysfunction, even when controlling for the presence of a major depressive episode in the last year. The findings of this study suggest that individuals with features of BPD experience relationship dysfunction that cannot be accounted for by comorbid depression and that perceived childhood emotional invalidation may contribute to these problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, anxiety, and resting frontal EEG asymmetry: A meta-analytic review.

Emotion-related disturbances, such as depression and anxiety, have been linked to relative right-sided resting frontal electroencephalograph (EEG) asymmetry among adults and infants of afflicted mothers. However, a somewhat inconsistent pattern of findings has emerged. A meta-analysis was undertaken to (a) evaluate the magnitude of effects across EEG studies of resting frontal asymmetry and depression, anxiety, and comorbid depression and anxiety and (b) determine whether certain moderator variables could help reconcile inconsistent findings. Moderate effects of similar magnitude were obtained for the depression and anxiety studies, whereas a smaller effect emerged for comorbid studies. Three moderating variables predicted effect sizes: (a) Shorter EEG recording periods were associated with larger effects among adults, (b) different operationalizations of depression yielded effects of marginally different magnitudes, and (c) younger infant samples showed larger effects than older ones. The current data support a link between resting frontal EEG asymmetry and depression and anxiety and provide a partial account of inconsistent findings across studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger and frontal brain activity: EEG asymmetry consistent with approach motivation despite negative affective valence.

The anterior regions of the left and right cerebral hemispheres have been posited to be specialized for expression and experience of approach and withdrawal processes, respectively. Much of the evidence supporting this hypothesis has been obtained by use of the anterior asymmetry in electroencephalographic alpha activity. In most of this research, however, motivational direction has been confounded with affective valence such that, for instance, approach motivation relates positively with positive affect. In the present research, we tested the hypothesis that dispositional anger, an approach-related motivational tendency with negative valence, would be associated with greater left- than right-anterior activity. Results supported the hypothesis, suggesting that the anterior asymmetry varies as a function of motivational direction rather than affective valence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the relative importance of "psychopathic" personality and alcoholism on neuropsychological measures of frontal lobe dysfunction.

Previous research indicated that certain behaviors associated with "psychopathic" personality may derive in part from dysfunction in the frontal lobe of the cerebral cortex (Gorenstein, 1982). However, the effects of substance abuse provide an alternative explanation for frontal lobe deficits in a psychopathic population. Hare (1984) demonstrated that psychopaths in a prison population did not appear to have frontal lobe impairments, but he did not attempt a replication of Gorenstein's study. In the present study we attempted such a replication and examined the relative effects of psychopathic personality and alcoholism on several measures of frontal lobe impairment. Results did not support a significant relation between frontal lobe impairment and psychopathic personality, nor do they provide support for a significant relation between frontal lobe impairment and level of general alcoholism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)