Age, attention, expertise, and time-sharing performance.

Time-sharing efficiency and resource allocation from a group of pilots with expertise in time-sharing and a group of nonpilots (ages 20–79 years) were examined. Participants performed 5 dual tasks that represented different degrees of structural similarity as characterized by the structure-specific resource model. Age, expertise, and structural similarity were found to interactively affect time-sharing performance through attentional resources. Age-related deficits in time-sharing were evident under conditions of intense attentional demands and when precise control was required. Modest expertise modulation of the age effects is likely to increase with more domain-specific time-sharing. The structure-specific resource model provided a useful framework for interpreting the relationship between aging and time-sharing performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual-task information processing in schizotypal personality disorder: Evidence of impaired processing capacity.

Working memory theories heavily rely on the concept of processing resources and the their efficient deployment. Some recent work with schizophrenia-spectrum patients has suggested that many associated cognitive impairments may be reduced to deficits in working memory, possibly related to reductions in information-processing capacity resources. In this study, 38 patients with schizotypal personality disorder (SPD), 22 patients with other personality disorders, and 14 healthy comparison participants performed a dual-task processing assessment that was designed specifically for use in this type of study. Participants recalled lists of digits at their predetermined maximum digit span and performed box-checking tests, first alone and then in a dual-task format. Instructions included equal prioritization of both tasks. SPD patients had significantly shorter digit spans, and they also showed more deterioration on both tasks. Performance operating characteristics curves indicated that SPD patients' reduced performance was not due to abnormal resource allocation strategies leading to strategic failures. The authors discuss the implications of these processing capacity limitations for understanding both the signature of cognitive impairment within the schizophrenia spectrum and general abnormalities in working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Politics, science, and the emergence of a new disease: The case of chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) emerged as a diagnostic category during the last decade. Initial research suggested that CFS was a relatively rare disorder with a high level of psychiatric comorbidity. Many physicians minimized the seriousness of this disorder and also interpreted the syndrome as being equivalent to a psychiatric disorder. These attitudes had negative consequences for the treatment of CFS. By the mid-1990s, findings from more representative epidemiological studies indicated considerably higher prevalence rates. However, the use of the revised CFS case definition might have produced heterogeneous patient groups, possibly including some patients with pure psychiatric disorders. Social scientists have the expertise to more precisely define this syndrome and to develop appropriate and sensitive research strategies for understanding this disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

P300 amplitude, externalizing psychopathology, and earlier- versus later-onset substance-use disorder.

P300 amplitude predicts substance use or disorder by age 21. Earlier- versus later-onset substance disorders may reflect different levels of an externalizing psychopathology dimension. P300 in adolescence may not be as strongly related to later-onset substance problems as it is to earlier-onset ones. In the present study, visual P300 amplitude was measured at age 17 in a community-representative sample of young men. Substance and externalizing disorders were assessed at approximately ages 17, 20, and 24. Earlier-onset (by age 20) substance disorder was associated with higher rates of externalizing disorders than were later-onset problems. P300 amplitude was reduced in subjects with earlier-onset substance disorders, relative to later-onset and disorder-free subjects. Amplitude was also reduced in subjects with an externalizing disorder but no substance disorder. Earlier-onset subjects had reduced P300, even in the absence of an externalizing disorder. The results could not be attributed to a concurrent disorder or to recent substance use at the time of the P300 recording. The findings are consistent with P300 indexing an externalizing spectrum. Earlier-onset substance disorders are more strongly related to P300 and externalizing than are later-onset problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Males and eating disorders: Gender-based therapy for eating disorder recovery.

Mental health professionals may wonder how males with eating disorders differ from females with eating disorders and how best to treat males with eating disorders. The eating disorder literature largely focuses on females. Limited research has examined assessment and treatment of eating disorders in males. This article offers a unique view of eating disorder treatment for males by integrating it with the literature on the psychology of men. Mental health professionals are given practical suggestions to guide eating disorder recovery in males. A case example shows treatment considerations for working with males with disordered eating behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females.

Prevention programs for eating disorders attempt to simultaneously prevent new cases from arising (primary prevention) and encourage students who already have symptoms to seek early treatment (secondary prevention), even though ideal strategies for these 2 types of prevention may be incompatible with each other. In the present study, an eating disorder prevention program was evaluated in a sample of female college freshmen. In the intervention, classmates who had recovered from eating disorders described their experiences and provided information about eating disorders. At follow-up, intervention participants had slightly more symptoms of eating disorders than did controls. The program may have been ineffective in preventing eating disorders because by reducing the stigma of these disorders (to encourage students with problems to seek help), the program may have inadvertently normalized them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective interference on the holistic processing of faces in working memory.

Faces and objects of expertise compete for early perceptual processes and holistic processing resources (Gauthier, Curran, Curby, & Collins, 2003). Here, we examined the nature of interference on holistic face processing in working memory by comparing how various types of loads affect selective attention to parts of face composites. In dual tasks, all loads impaired overall performance on face judgment compared with no load. However, a face load reduced holistic face processing (Experiment 1) whereas an object load did not, regardless of expertise (Experiments 2 and 3). Also, 2 types of faces produced asymmetrical interference on each other (Experiment 4), refuting the hypothesis that any faces would produce equal interference. Thus, the interference on holistic face processing in working memory does not depend on overlap in expertise or face processing, but may be modulated by limitations in encoding or maintenance of highly similar representations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body image disturbance in body dysmorphic disorder and eating disorders. Obsessions or delusions?

At this time, the question posed by this article's title--body image disturbance in body dysmorphic disorder and eating disorders: obsessions or delusions?--is probably best answered "both." Both disorders appear to be characterized by obsessional and delusional thinking. In addition, it is likely that their nondelusional and delusional variants constitute a single disorder encompassing a spectrum of insight, with the entire spectrum characterized by obsessional thinking. This view represents a considerable departure from DSM-III-R, in which the psychotic disorders were encapsulated in a separate section of the manual and considered different disorders from their nonpsychotic variants. The one exception was the mood disorders, which were acknowledged to have psychotic variants that were classified in the manual's "nonpsychotic" section. In DSM-IV, on the basis of emerging empirical evidence about the dimensional nature of the psychotic/nonpsychotic boundary, the dichotomy between delusional and nondelusional disorders is less clear. The double coding allowed for BDD acknowledges that BDD and its delusional disorder variant may constitute a single disorder; that allowed for OCD acknowledges that OCD may be delusional. With regard to eating disorders, however, DSM-IV is surprisingly silent, perhaps because delusional preoccupations are less common than in BDD. These issues also may apply to other disorders. Like BDD, hypochondriasis is classified as a somatoform disorder, with its delusional variant a type of delusional disorder, somatic type. Do the delusional and nondelusional variants of hypochondriasis constitute the same disorder? Do other types of somatic delusional disorder, such as parasitosis and olfactory reference syndrome (the belief that one emits a foul body odor) have nondelusional variants? It is likely that a number of disorders span a spectrum from delusional to nondelusional thinking, with unlimited shades of gray in between. Future research may indicate that obsessional disorders such as BDD, anorexia, OCD, and hypochondriasis, as well as other disorders such as major depression, should have qualifiers or subtypes--for example, "with good insight," "with poor insight," and "with delusional (or psychotic) thinking"--with an implied continuum of insight embraced by a single disorder. Such an approach, which scatters psychosis throughout the nomenclature, ultimately may be shown to be a more valid and clinically useful classification approach. Answers to these questions will not only improve our classification system but also may have important treatment implications. For example, the preliminary finding that delusional BDD responds preferentially to SRIs but not to neuroleptic agents contradicts conventional wisdom about the treatment of psychosis.(ABSTRACT TRUNCATED AT 400 WORDS)     

Implicit measures of association in psychopathology research.

Studies obtaining implicit measures of associations in Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision; American Psychiatric Association, 2000) Axis I psychopathology are organized into three categories: (a) studies comparing groups having a disorder with controls, (b) experimental validity studies, and (c) incremental and predictive validity studies. In the first category, implicit measures of disorder-relevant associations were consistent with explicit beliefs for some disorders (e.g., specific phobia), but for other disorders evidence was either mixed (e.g., panic disorder) or inconsistent with explicit beliefs (e.g., pain disorder). For substance use disorders and overeating, expected positive and unexpected negative associations with craved substances were found consistently. Contrary to expectation, implicit measures of self-esteem were consistently positive for patients with depressive disorder, social phobia, and body dysmorphic disorder. In the second category, short-term manipulations of disorder-relevant states generally affected implicit measures as expected. Therapeutic interventions affected implicit measures for one type of specific phobia, social phobia, and panic disorder, but not for alcohol use disorders or obesity. In the third category, implicit measures had predictive value for certain psychopathological behaviors, sometimes moderated by the availability of cognitive resources (e.g., for alcohol and food, only when cognitive resources were limited). The strengths of implicit measures include (a) converging evidence for dysfunctional beliefs regarding certain disorders and consistent new insights for other disorders and (b) prediction of some psychopathological behaviors that explicit measures cannot explain. Weaknesses include (a) that findings were inconsistent for some disorders, raising doubts about the validity of the measures, and (b) that understanding of the concept “implicit” is incomplete. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbidity of personality disorders and unipolar major depression: a review

The association of major depressive disorders with personality disorders is relevant in terms of clinical, therapeutic and prognostic aspects. However, the prevalence of this association remains unclear. This may be due to methodological considerations. Nonetheless, it could be estimated from this review that 20% to 50% of inpatients and 50% to 85% of out-patients with a current major depressive disorder have an associated personality disorder. Cluster B personality disorders, in particular borderline (10-30%), histrionic (2-20%) and antisocial (0-10%), seem to be overrepresented, even if the narcissistic one is rare (less than 5%). The main characteristic of Cluster C personality disorders is the great variability of results across studies, except for the obsessive compulsive personality disorder, whose prevalence is consistent and rather high (0-20%). Cluster A personality disorders are an heterogeneous group, since the prevalence of schizotypal personality disorder is rather high (0-20%), the prevalence of paranoid personality disorder is low (less than 5%) and the prevalence of schizoid personality disorder is quite variable from one study to another. The prevalence of personality disorders among patients with a lifetime major depression has been insufficiently studied, although it may concern half of these patients. The prevalence of current of lifetime major depression among patients with a personality disorder has not been sufficiently studied and results are very scattered. Also, the coexistence of personality disorder and major depression is frequent, and this review emphasizes the heterogeneity of the personality styles associated with major depression. Finally, an optimization of methods and the adjunction of a dimensional point of view to the categorical approach may help to study the comorbidity of major depression and personality disorders and its consequences.     

Psychiatric comorbidity in women with binge eating disorder: Prevalence rates from a non-treatment-seeking sample.

This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates for major depression. any Axis I disorder, and any Axis II disorder relative to controls. BED women also evidenced greater eating and psychiatric symptomatology than did controls. Results suggest that the prevalence of comorbid psychiatric disorders in BED may be lower than previously indicated by clinical studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Course of psychiatric and substance abuse syndromes co-occurring with bipolar disorder after a first psychiatric hospitalization

BACKGROUND: Patients with bipolar disorder frequently meet criteria for other psychiatric and substance abuse diagnoses. To clarify relationships among these disorders, the authors examined the course of syndromes co-occurring with bipolar disorder for 12 months after a first hospitalization. METHOD: Seventy-seven patients were recruited from consecutive inpatient admissions who met DSM-III-R criteria for bipolar disorder, manic or mixed with psychosis. The 12-month syndromal course of co-occurring DSM-III-R alcohol and drug abuse disorders, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other anxiety disorders were longitudinally recorded. RESULTS: The rates of all syndromes, except other anxiety disorders, were elevated. OCD demonstrated an interval course that frequently mirrored the course of the bipolar disorder. The courses of PTSD and substance abuse syndromes were separate from that of the bipolar disorder in many of those with both syndromes. Alcohol and drug abuse syndromes were strongly correlated. CONCLUSION: The obsessive-compulsive syndrome may represent an alternative expression of bipolar disorder in some patients. In contrast, PTSD appears to represent a truly separate disorder, which is possibly more prevalent in bipolar patients due to a shared risk factor. Substance abuse does not appear to simply result from attempts at self-medication or from the impulsivity of mania. These results suggest that future studies examining the course of syndromes co-occurring with bipolar disorder are warranted.     

Revisiting the latent structure of eating disorders: Taxometric analyses with nonbehavioral indicators.

Researchers have debated whether clinical eating disorders are best conceptualized as one extreme along a continuum of degree or as qualitatively different from less severe eating disturbances. Taxometric analysis, a set of procedures that assess the structure of a given disorder by detecting whether a latent taxon exists among its indicators, has just begun to be applied to eating disorder research. Its application to this domain may clarify whether eating disorders best conform to a dimensional (i.e.. continuum) or taxonic model. The latent structure of eating disorders was examined in a sample of 532 college women by using 2 popular taxometric procedures (i.e., maximum covariance analysis and latent mode analysis) with 5 nonbehavioral indicators of eating disorder symptomatology. Results across procedures suggest that the data are more indicative of a dimensional solution, as no latent taxon was uncovered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An attentional model of dimensional contrast.

In this article, the authors introduce a model of dimensional stimulus control designed to explain dimensional contrast effects. The model suggests that dimensional contrast is the result of the nonuniform allocation of limited attentional resources during discrimination training. Attention in the model is conceived as a gradient that extends throughout a spatial representation of stimuli. The authors examine the results of 5 experiments to assess the quality of fit of the model and its theoretical implications. Variations in training procedures, such as changing presentation probability of stimuli, changing the distribution of training stimuli, and changing the relative difficulty of discrimination, can all be accounted for by differences in the allocation of attentional resources. The good fit of the model indicates that attentional limitations may play an important role in stimulus control phenomena such as dimensional contrast. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular modulation of prefrontal cortex: Rational development of treatments for psychiatric disorders.

Dysfunction of the prefrontal cortex (PFC) is a central feature of many psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD), schizophrenia, and bipolar disorder. Thus, understanding molecular influences on PFC function through basic research in animals is essential to rational drug development. In this review, we discuss the molecular signaling events initiated by norepinephrine and dopamine that strengthen working memory function mediated by the dorsolateral PFC under optimal conditions, and weaken working memory function during uncontrollable stress. We also discuss how these intracellular mechanisms can be compromised in psychiatric disorders, and how novel treatments based on these findings may restore a molecular environment conducive to PFC regulation of behavior, thought and emotion. Examples of successful translation from animals to humans include guanfacine for the treatment of ADHD and related PFC disorders, and prazosin for the treatment of PTSD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The effects of story structure on the recall of stories in children with attention deficit hyperactivity disorder.

This study explored influences of story structure properties on recall of story events by children with and without attention deficit hyperactivity disorder (ADHD). Participants listened to and retold 2 stories. Two properties of the stories' causal structure were derived: the number of causal connections an event has to other events and whether an event is on the causal chain linking events from beginning to end. The extent to which causal properties and the more subjective property of perceived importance predicted recall in the 2 groups of children was examined. Each property predicted recall, but there were group differences in sensitivity to causal structure that were moderated by intelligence level and gender. Variations in amount and allocation of cognitive resources applied to comprehension contributed to performance of children with ADHD. There are implications for understanding academic and social difficulties common in children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When authorities' commands backfire: Attributions about consensus and effects on deviant decision making.

The perception of consensus typically produces conformity, but specific attributional circumstances may produce deviance instead. Ironically, the command of an authority figure may create one such circumstance. Participants were presented with scenarios in which they had to make a choice between 2 options. Prior to their decision, they observed others all making a single choice. In some conditions, this consensus occurred following an authority's explicit command to make that choice. Results revealed the hypothesized effect--the authority's command led participants to make deviant decisions-and revealed that this effect was moderated by the authority's continued presence, expertise, the target(s) of the command, and the ability of perceivers to use their cognitive resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetics of personality disorders: Perspectives from personality and psychopathology research.

Although the field is young, studies pertinent to genetic hypotheses have accumulated for several personality disorders. Genetic links to personality disorders from the domains of normal personality and Axis I disorders are reviewed. Evidence of a link to schizophrenia is clearest for schizotypal and less conclusive for paranoid and schizoid personality disorders. A genetic association between borderline personality disorder and affective disorders has not been clearly supported, but there may be a subtype genetically linked to affective disorders. Evidence of genetic influence is mixed for obsessive-compulsive personality disorder. In general, greater attention to dimensional phenotypic measures and multivariate designs can yield more definitive answers regarding the correct subtyping and probable etiology of personality disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Divided attention in youth-onset psychosis and attention deficit/hyperactivity disorder.

The authors used pupillary dilations to test whether divided attention deficits in youth-onset psychosis and attention deficit/hyperactivity disorder (ADHD) were because of limitations in recruitment of cognitive resources or abnormalities in attention allocation. Eight- to 19-year-olds with youth-onset psychosis or ADHD were administered a divided attention test consisting of an auditory digit span (DS) task and a simple visual response time (RT) task. In 4 conditions, participants performed neither (no task), 1 (DS or RT only), or both tasks (dual). Dependent variables were DS accuracy, RT, and pupillary dilation to digits as an estimate of recruitment of cognitive resources. The authors found no evidence for an abnormal attention strategy in either disorder. Instead, results were consistent with the hypothesis that both clinical groups have limitations in resource recruitment. These limitations were more severe in psychosis than in ADHD. Findings indicate that both clinical groups had difficulties in regulating physiological arousal on a moment-to-moment basis in accordance with task demands. Findings also demonstrate the importance of taking into account difficulties that constrain performance on simple tasks before interpreting impairments on complex tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The utility of motivational interviewing as an adjunct to exposure therapy in the treatment of anxiety disorders.

Motivational interviewing (MI; W. R. Miller & S. Rollnick, 2002) was designed as a prelude to standard substance use treatment. Because of its purported capacity to resolve ambivalence about change, MI has been applied to many other behavioral and mental health problems. Ambivalence about engaging in exposure-based therapies is common among those with anxiety disorders, and systematic efforts (e.g., MI) to ameliorate such ambivalence may yield superior clinical outcomes. The use of MI as an adjunct intervention to standard exposure therapy in anxiety disorders is explored with a focus on treatment retention and adherence. Shared and disparate treatment difficulties among substance use and anxiety disorder populations suggest that MI may be especially effective with anxiety disorders. Empirical evidence supporting the use of MI with substance abuse and anxiety disorder populations is presented. Practical aspects of MI's clinical application as an adjunct intervention to standard exposure therapies for anxiety disorders are discussed. Last, a future research agenda is delineated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)