Schizophrenia susceptibility and chromosome 6p24-22.
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Biomedical subjects
Publications and source records attributed to L Sharpe.
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The present study investigated the role of arousal in problem gambling. Three groups of subjects were recruited into the study corresponding to problem gamblers, high and low frequency social gamblers. For the two gambling groups, the preferred form of gambling was poker machine playing. Five different conditions were employed in order to determine under which conditions gambling related cues were related to increased autonomic arousal, as measured by skin conductance level (SCL), heart rate (HR) and frontalis electromyography (EMG). The five conditions were a neutral task, a videotaped poker machine gambling scenario presented with and without distraction, a personally relevant "win" situation and a videotaped horse race. Comparisons between responses for the videotaped poker machine gambling stimuli versus a horse-racing video task demonstrated differences only for the problem gambling group and only for SCL. No differences between these tasks emerged on the HR and EMG indices and no differences were evident for either of the social gambling groups. No changes were observed in any group when subject's cognitions were prevented by asking patients to count the number of wins made during the video play period while watching the same poker machine video. However, when personally relevant situations were presented and compared to a neutral task, differences were observed in all three groups. However, the nature of these differences varied between the groups and the different indices of arousal. For problem gamblers, increases were evident in all three measures. Increases were also observed for the control groups in comparison to the neutral task, but only in HR and SCL and not for EMG. For HR, the increases were equivalent across all three gambling groups. However, for SCL the problem gambling group became significantly more aroused than the control groups, but no differences were observed between the high and low frequency gamblers. Only the problem gambling groups evidenced significant increases in the personally relevant task compared to the neutral task for EMG. Theoretical and clinical implications of these results for the development, maintenance and treatment of problematic levels of gambling are discussed.
In a preliminary genome scan of 47 bipolar disorder families, we detected in one family a lod score of 3.41 at the PFKL locus on chromosome 21q22.3. The lod score is robust to marker allele frequencies, phenocopy rates and age-dependent penetrance, and remains strongly positive with changes in affection status. Fourteen other markers in 21q22.3 were tested on this family, with largely positive lod scores. Five of the other 46 families also show positive, but modest lod scores with PFKL. When all 47 families are analysed together, there is little support for linkage to PFKL under homogeneity or heterogeneity using lod score analysis, but the model-free affected-pedigree-member method yields statistically significant results (p < 0.0003). Our results are consistent with the presence of a gene in 21q22.3 predisposing at least one family to bipolar disorder.
A series of 57 extended pedigrees with high density of bipolar affective disorder is described. Ascertainment and diagnostic procedures are documented and simulation studies to assess statistical power are carried out. The pedigrees, obtained in the US and Israel, are comprised of 1508 adult individuals with best estimate consensus diagnoses (12-71 relatives per pedigree), 490 of whom (including 401 sib pairs) meet criteria for a conservative disease definition (bipolar disorder or recurrent major depression). Cell lines have been established on 1324 of these individuals. Statistical power to detect linkage with lod score analysis, assuming autosomal dominant transmission and highly polymorphic DNA markers, is nearly 100% for alpha (proportion of linked families) = 30%, and 75% for alpha = 20%. This is the largest bipolar pedigree series reported to date; its unique features make it amenable to various gene detection techniques.
Changes in coping skills and problem-solving skills were examined in two groups of schizophrenic patients. The groups received either coping skills enhancement or problem-solving treatments to reduce their drug-resistant residual psychotic symptoms. The coping skills group showed significant increases both in the number of positive coping strategies used and in their efficacy, whereas the problem-solving group showed a decrease in these measures during treatment. Both groups showed significant improvements in problem-solving skills. Changes in coping but not problem solving were significantly related to decreases in psychotic symptoms during treatment. It was concluded that treatment involving the teaching of coping skills had a specific treatment effect.
The present paper reports a case study documenting the success of a child-appropriate variant of eye movement desensitization (EMD) in the treatment of post-traumatic stress disorder (PTSD). Although there have been numerous case studies and some preliminary controlled trials of this method in adult cases of PTSD, there does not appear to be any information on its use in children. The available literature suggests that it is a more rapid and less traumatic treatment than traditional exposure based therapies. The present paper describes a child-appropriate auditory variant of eye-movement desensitization applied to a case of childhood PTSD.
A heuristic model to account for the development and maintenance of problem gambling is provided with the aim of directing clinical management and future research. Previous explanations of problem gambling have been limited in two main ways. Firstly, the models have been primarily descriptive, and secondly they have generally lacked clinical value. Most explanations have ignored the mechanisms through which this behaviour becomes problematic, and have not identified the relationships between different variables.
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The etiology of premenstrual syndrome is unknown. A wide variety of etiological explanations has been suggested, but controlled studies based on these theories have generally failed to provide confirmation. This article reviews the literature on treatment of premenstrual symptoms and provides some practical suggestions for clinical management.
A case of peritoneal melanosis secondary to a ruptured benign cystic teratoma in a 28-year-old woman is reported. The patient had no history of cutaneous or ocular malignant melanotic lesions. The section of the left ovary contained benign teratoid elements. The ultrastructure of the omental and peritoneal pigmented nodules confirmed that the lesions consisted of histiocytes phagocytizing massive melanin pigments. Although no melanocytic neoplasm was found in the ovarian cystic teratoma, circumstance suggests that the ovarian, omental, and peritoneal pigmented lesions were secondary reactions to melanin released from the ruptured cystic teratoma.
A long-term follow-up of 19 women who participated in short-term group therapy for anorgasmia using masturbation and assertiveness training showed that the majority of women maintained treatment gains and progressed further in orgasm response and other aspects of sexual functioning, including assertiveness and liberalness of sexual attitudes. However, several women regressed, and four additional women who dropped out of treatment also improved dramatically in orgasm response, suggesting that other patient characteristics and factors affect apparent treatment outcome. Independent evaluations, standardized assessment scales, long-term, in-person follow-ups and multidimensional assessment are useful in evaluating treatment effectiveness.
This paper reviews some important clinical and research implications of studies which have evaluated the effectiveness of short-term behavioral group therapy for anorgasmia. Though formal research data on curative factors is very sparse, the experience of sharing within a group, and the focus on arousal seem consistent with treatment outcome; however, the emphasis on assertiveness and the woman-only approach may have countertherapeutic as well as therapeutic effects. A potentially important intervening variable is the woman's level of ego development. The use of certain assessment scales and criteria for success of treatment are critiqued, and recommendations made for further study.
The increasing need expressed by clinicians and researchers alike for valid and reliable psychological measures of sexual behavior and adjustment contrast with the limited available information on the assessment of human sexual functioning. The aim of this article is to present relevant data on the psychometric characteristics of scales designed to measure one or more aspects of human sexual activity and marital interaction. This list is by no means exhaustive but covers most assessments of either individuals or dyads, mainly in a heterosexual context. Under the title of the scales, which have been arranged by alphabetical order according to the first author's name, the information provided may permit a preliminary judgment concerning the potential applicability of the instrument to the reader's need.
The association between lateralized hemispheric dysfunction and psychiatric diagnosis was investigated with a measure of summation of dichotic clicks and with a dichotic competing message task. Ear asymmetries of affective psychotic patients were similar to those of right temporal lesioned controls and differed from those of schizophrenic patients and normal controls. In contrast, schizophrenic patients did not display abnormal auditory perceptual asymmetries.
A standardized, semi-structured interview for examining and recording the mental state in elderly subjects is described. It allows the classification of patients by symptom profile and can demonstrate changes in that profile over time. It is believed that good reliability is demonstrated between psychiatric raters both for psychiatric diagnosis made on the basis of the schedule findings and for individual items. The Geriatric Mental State Schedule (GMS) consists mainly of items from the eighth edition of the PSE (Wing et al. 1967), together with additional items from the PSS (Spitzer et al. 1964), and extra sections dealing with disorientation and other cognitive abnormalities. Modifications have been introduced to facilitate interviewing elderly subjects.
One hundred geriatric psychiatric patients were examined with the Geriatric Mental State Schedule in New York and London, and a correlation procedure involving both clinical and statistical operations was carried out on the psychopathological data thus collected. Twenty-one factors were produced, including three dealing with cognitive impairment. Although it was found that elderly depressives show a profile of psychopathology quite different from that shown by patients with organic disorder, it was also found that patients with an apparently functional disorder may sometimes be diagnosed as an organic disorder, that subjective complaints of intellectual impairment are not good indicators of organic disorders, and may be associated with a depressive factor, and that complaints that could be dismissed as attributes of aging may actually be indicative of a depressive disorder in the elderly. The methodological implications, as well as the limitations of the sample size, are discussed.
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.