Verbal Representation and Therapeutic Change in Anaclitic and Introjective Inpatients.

This study examined the relation between changes in clinical functioning and changes in verbal expression in 81 seriously disturbed and treatment-resistant young adults seen in a comprehensive, psychoanalytically oriented inpatient treatment. Clinical functioning was evaluated with a battery of clinical and social measures. Verbal representations were assessed using computer-assisted scoring of Thematic Apperception Test responses. Changes in the frequency of verbal content and style in the narratives of these patients covaried with changes in clinical functioning. Significantly different covariations of verbal and clinical change, particularly differences in covariates of referential activity, were found for patients with anaclitic versus introjective personality configurations. The implications of these findings for understanding and treating severe psychopathology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mixed anaclitic-introjective psychopathology in treatment-resistant inpatients undergoing psychoanalytic psychotherapy.

Utilizing data from the Riggs-Yale Project, 45 male and 45 female 18-29-year-old treatment-resistant inpatients undergoing intensive psychoanalytically oriented treatment were studied. Twenty-seven mixed-type anaclitic-introjective inpatients were compared with 29 "pure" anaclitic and 34 "pure" introjective inpatients. At intake, mixed-type inpatients were more clinically impaired (i.e., were more symptomatic, cognitively impaired, and thought disordered) and more vulnerable (i.e., less accurate object representations and more frequently used maladaptive defense mechanisms) in comparison with clearly defined anaclitic and introjective patients. Mixed-type patients, however, improved significantly more in the course of psychoanalytically oriented treatment, in terms of clinical functioning (i.e., symptoms, cognitive functioning) and psychological vulnerability (i.e., utilization of more adaptive defense mechanisms). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The functional reanimation of paralyzed limbs.

The functional reanimation of paralyzed limbs has been a longstanding goal of neural prosthetic research, but clinically successful applications have been elusive. Natural voluntary limb movement requires four major elements: actuators (i.e., motor units), sensors (i.e., somatosensory afferents), commands (i.e., cerebral cortical activity), and control (i.e., integration of the previous three elements at various levels of the neuraxis). Prosthetic equivalents of each of these elements are, as yet, primitive and often cumbersome to deploy, but new technologies promise substantial improvements for all. This article focuses on one such technology, bionic neuon (BION) modular microimplants, and its relationship to alternative and complementary technologies. The challenge remains to select and integrate them into systems that can be tailored efficiently to the widely disparate needs of patients with various patterns of weakness and paralysis.     

Saccadic system functioning among schizophrenia patients and their first-degree biological relatives.

In Study 1, 30 schizophrenia Ss and 27 nonpsychiatric comparison Ss were presented with a fixation task, a visually guided reflexive saccade (prosaccade) task, a predictive tracking task (0.4-Hz square wave), and an antisaccade task. The 2 groups did not differ on either the fixation or prosaccade tasks. Schizophrenia Ss had an increased number of errors on the antisaccade task and had decreased rightward visually guided saccade amplitudes during the predictive tracking task. In Study 2, 13 psychiatric comparison Ss and 32 1st-degree biological relatives of the schizophrenia Ss were compared with the schizophrenia Ss and a larger and older sample of nonpsychiatric Ss (n?=?33) on the predictive tracking and antisaccade tasks. The groups did not differ on predictive saccadic tracking. The schizophrenia Ss and their 1st-degree biological relatives made more errors on the antisaccade task than both the nonpsychiatric and psychiatric comparison groups (who did not significantly differ). Results are consistent with the notion that dysfunction of dorsolateral prefrontal cortex, caudate nucleus, or both is related to liability for schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cigarette smoking and submaximal exercise test duration in a biracial population of young adults: the CARDIA study

Symptom-limited, graded exercise treadmill testing was performed by 4,968 white and black adults, ages 18-30 yr, during the baseline examination for the Coronary Artery Risk Development in Young Adults (CARDIA) study. Compared with nonsmokers, the mean exercise test duration of smokers was 29-64 s shorter depending on race/gender group (all P < 0.001), but mean duration to heart rate 130 (beats.min-1) ranged from 20-50 s longer (P < 0.05). In each race/gender group, test duration to heart rates up to 150 was 15-35 s longer (P < 0.05) in smokers than in nonsmokers after adjustment for age, sum of skinfolds, hemoglobin, and physical activity score. The mean maximum heart rate was lower in smokers than in nonsmokers (difference ranging from 6.7 beats.min-1 in white men to 11.2 beats.min-1 lower in black women, P < 0.001), although maximum rating of perceived exertion was nearly identical in smokers and nonsmokers. Chronic smoking appears to blunt the heart rate response to exercise, so that exercise duration to submaximal heart rates is increased even though maximal performance is impaired. This may result from downloading of beta-receptors caused by smoking. Smoking status should be considered in the evaluation of physical fitness data utilizing submaximal test protocols, or else the fitness of smokers relative to nonsmokers is likely to be overestimated.     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of muscle immobilization at different lengths on tetrodotoxin-induced disuse atrophy

Previous studies have shown that immobilization causes muscle atrophy and that the rate of atrophy depends on the length at which the muscle is immobilized. However, most studies have been carried out in neurologically intact animals that were capable of generating at least some voluntary muscle activation. In this study, terrodotoxin was applied chronically to the rat sciatic nerve to produce complete paralysis of distal muscles for seven days, and the ankle was immobilized to hold the muscles at long or short lengths. Paralysis without immobilization resulted in relative weight losses of 36% for soleus, 19% for tibialis anterior (TA), and 17% for lateral gastrocnemius (LG) muscles. Casting the ankle in plantarflexion stretched TA and reduced its weight loss to 10%. Soleus and LG were shortened by this intervention and had increased losses of 43% and 28%, respectively. Fixing the limb in dorsiflexion resulted in a posture similar to that adopted by the unrestrained rats and had no significant effect on the amount of muscle atrophy compared to that in unrestrained paralyzed animals.     

Value of early variables as predictors of short-term outcome in patients with acute focal cerebral ischemia

The pathogenesis of essential thrombocythemia as a clonal myeloproliferative disorder has been clearly established. However, there continues to be considerable controversy concerning the management of this disease, particularly because its natural history is consistent with a nearly normal life expectancy. Therapeutic decisions have been complicated by a reliance on largely anecdotal, retrospective experience in the medical literature and, until very recently, an absence of prospective, controlled clinical trials. A recent study of patients with essential thrombocythemia at high risk of thrombosis because of advanced age or previous history of thrombotic complications demonstrated that platelet cytoreduction with hydroxyurea is effective in reducing thrombotic complications. Other cytoreducing agents that have been used in this disease include alkylating agents, recombinant interferon alpha, and anagrelide. The use of antiplatelet therapy is also controversial, and is most highly effective in patients with digital or cerebrovascular ischemic problems.