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M Alpert

Publications and source records attributed to M Alpert.

At least 55 records · Page 3Linked to original sources
PubMed1994

A multimethod, multichannel assessment of affective flattening in schizophrenia.

Flat affect was examined across multiple contexts (during interviews and emotional films), multiple channels of expression (facial and vocal), and different assessment techniques (clinical ratings, observational ratings of facial expression, and acoustic analyses) in 23 medication-free schizophrenic patients. Patients participated in three different interviews during which either clinical ratings were made or their voices were audiotaped for later acoustic analyses. Patients were also videotaped while they viewed positive and negative emotional films. The videotapes were then coded for the frequency, intensity, and duration of positive and negative facial expressions. Results indicated that general clinical ratings were related across different interviews. However, only those items specific to affective flattening bore significant relationships to vocal and facial expressiveness. Vocal expressiveness and negative facial expressiveness were related, but vocal expressiveness was not related to positive facial expressiveness.

Adult↗
PubMed1994

The syntactic role of pauses in the speech of schizophrenic patients with alogia.

This study examines the relation between alogia and pausing. The authors analyzed the flow of speech of 17 male schizophrenic patients during an interview, particularly the pauses that occurred within and between syntactic clauses and those that occurred as the turn switched from the interviewer's question to the patient's response. The strongest predictor of alogia ratings was the duration of switching pauses; the frequency of long within-clause pauses was also significantly related to alogia, but the frequency of between-clause pauses showed a trend toward a negative relation with alogia. Words following within-clause pauses were more likely to be content words than function words, and the content words were less frequent in the English language than the speaker's other words. This suggests that alogic patients have difficulty in word finding and in thought formulation, as well as a general increase in the duration of all pauses.

Adult↗
PubMed1994

Pursuit eye movements in chronic schizophrenics: relationship between increased saccades and negative symptoms.

Smooth pursuit eye movements of chronic schizophrenics (n = 16) and controls (n = 10) were recorded while subjects tracked a sinusoidally-moving target. Negative symptoms in schizophrenics were rated using the Schedule for the Assessment of Negative Symptoms. An increased frequency of smooth pursuit eye movement abnormalities was found in the schizophrenic group, including greater variability of gain and more frequent and larger saccades. Frequency of saccades was positively correlated with the Negative Symptoms scales for attentional impairment and alogia. The results confirm findings of eye movement dysfunction in schizophrenics and provide new evidence that the motor and cognitive dysfunctions of schizophrenia may be related.

Adult↗
PubMed1994

Scales for the assessment of neuroleptic response in schizophrenic children: specific measures derived from the CPRS.

This article reports the psychometric properties of two scales for rating positive and negative schizophrenic signs and symptoms. These Positive and Negative Syndrome Scales consist of items selected from the Children's Psychiatric Rating Scale (CPRS), which contains items covering a wide range of childhood psychopathology. CPRS rating data were analyzed for 19 schizophrenic children, 16 males and 3 females, mean age 8.9 years (range 5.5-11.7), evaluated in a double-blind, placebo-controlled crossover study of haloperidol. We describe the item composition and coherence of each scale, the interrater reliabilities of clinicians using the scales, and the sensitivity of the scales for resolving treatment response. Schizophrenic children showed both positive and negative signs and symptoms, and both improved with neuroleptic treatment.

Antipsychotic Agents↗
PubMed1993

Mapping schizophrenic negative symptoms onto measures of the patient's speech: set correlational analysis.

We describe a system designed to assess the speech behaviors that inform clinicians about their patients' negative symptoms. Measures are formed into scales to reflect the patient's Pausing, Speech Rate, and Dyadic Interaction with the interviewer. Using set correlation, we examined the associations between the acoustic scales and the clinician's ratings of Flat Affect, Alogia, and Asociality. Over half of the multivariance in the clinical scales was accounted for by the acoustic scales. Unique isomorphisms between the acoustic and rating scales were found for: Dyadic Interaction with Flat Affect; Pause Production with Alogia; and Rate with Asociality.

Adult↗
PubMed1993

Perception of facial emotion in schizophrenic and right brain-damaged patients.

Deficits in the perception of facial emotion have been demonstrated in patients with right-sided brain damage (RBD) and schizophrenia (SZ). Furthermore, recent speculations have implicated right-hemisphere dysfunction in Type II schizophrenics, especially those with a preponderance of "negative symptoms" and flat affect. The performance of SZ, RBD, and normal control subjects was compared on measures assessing facial emotional perception. Both identification and discrimination paradigms were used, with positive/pleasant and negative/unpleasant emotions. To examine the effects of visuospatial and facial processing on facial emotion tasks, the Visual Matrices Test and the Benton Facial Recognition Test were administered. On both facial emotion tests, SZ and RBD patients were significantly impaired relative to normal subjects, but not different from each other. The SZ and RBD patients were also impaired on the matrices and facial recognition tests. When the effects of the matrices and neutral face recognition tests were statistically controlled, significant group differences remained for the identification task but not for the discrimination task. Thus, methodologies are presented for the neuropsychological study of facial emotional perception, and some support is provided for the notion that negative-symptom schizophrenia is associated with right hemisphere dysfunction.

Adult↗
PubMed1993

Autistic children on followup: change of diagnosis.

The present study compared baseline assessments of 30 autistic children studied at ages 2.8 to 6.3 years (mean = 4.5; median = 4.5) with assessments at followup 0.38 to 14.3 years later (mean = 5.05; median = 4.33). The assessments included diagnosis, Severity of illness, and intellectual functioning. At the time of followup, when they participated in the American Psychiatric Association's DSM-IV Field Trial, the subjects' ages ranged from 5.5 to 19.25 years (mean = 9.60). At followup, a clinical diagnosis of autistic disorder was made in 22 of the 30 children; autistic disorder, residual state was diagnosed in 6 children, and pervasive developmental disorder not otherwise specified (PDDNOS) was diagnosed in 2 children. The group of children who, on followup, no longer met the diagnosis of autistic disorder had lower severity of illness ratings and higher intellectual functioning at baseline and at followup than those children who remained diagnosed as autistic disorder; they also showed a rise in intellectual functioning over time whereas those children who remained diagnosed as autistic did not. Both groups showed decreases in severity of illness over time.

Adolescent↗
PubMed1991

The effects of electromyographic feedback training on suppression of the oral-lingual movements associated with tardive dyskinesia.

The efficacy of electromyographic feedback training in reducing the magnitude and frequency of the oral-lingual movements associated with tardive dyskinesia (TD) was investigated in a groups design. Twenty adult male inpatients diagnosed as having TD using the Abnormal Involuntary Movements Scale (AIMS) were randomly assigned to one of two treatment conditions. Following identification, all participants were initially reduced to the lowest effective dosage of neuroleptics, and then discontinued from anticholinergics. Following one month on this regimen, they were given a course of feedback training consisting of ten 14-minute sessions. Group one participants were provided with a tone contingent upon oral-lingual movements above a yoked threshold. Group two participants were given noncontingent feedback tones generated randomly. Weekly AIMS were administered as well as an initial baseline during each session to determine current level of oral-lingual activity. An analysis of session effects indicated significantly more suppression of oral-lingual activity in the contingent group versus the noncontingent feedback group. Jaw and forehead activity also measured showed reductions of similar magnitudes for both groups.

Aged↗
PubMed1991

Parathyroid function in normocalcemic renal transplant recipients: evaluation by calcium infusion.

The extent to which secondary hyperparathyroidism may involute remains poorly defined. Renal transplantation offers a clinical situation in which metabolic stimuli for hyperparathyroidism are removed. To examine whether hyperparathyroidism resolves after transplantation, we evaluated 11 renal transplant recipients who had been normocalcemic 6 or more months after transplantation using a sensitive 2-site immunoradiometric assay for intact serum PTH. Nine of the 11 had PTH concentrations within the normal range. Of these 9, 6 were found to have abnormal parathyroid function when challenged with an iv calcium infusion. The other 2 patients demonstrated significantly elevated basal PTH concentrations and elevated ionized calcium despite normal total serum calcium and albumin concentrations. In both, the PTH response to infused calcium was markedly abnormal, confirming hyperparathyroidism. The estimated renal threshold phosphate concentration was low in 4 of 9 patients with normal basal PTH concentrations and in both with elevated basal PTH. Bone mineral density, measured at the radius by single photon absorptiometry and at the spine by dual energy x-ray absorptiometry, was normal in 8 of the 9 transplant recipients who had normal basal PTH concentrations.

Adult↗
PubMed1990

Lateralization for the expression and perception of facial emotion as a function of age.

In order to test the hypothesis of right hemisphere changes with age, this study examined lateralization for facial emotion in young, middle-aged, and older women (N = 90). For expression, subjects were photographed while posing positive and negative emotions. Composite photographs were created and rated for intensity. For perception, subjects were required to make intensity judgements about emotional chimeric faces. Overall, subjects demonstrated significant left-sided facial asymmetry for expression and significant left hemispace biases for perception. The findings for facial expression were not influenced by emotional valence or resting face asymmetries. There were no changes in lateralization as a function of age for either expression or perception. Taken together, these findings lend support to the notion that the right hemisphere mediates emotional processing across the adult life span.

Adult↗
PubMed1990

Perceiver and poser asymmetries in processing facial emotion.

This study examined both perceiver and poser asymmetries in processing facial emotion. Posers were left brain-damaged (LBD), right brain-damaged (RBD), and normal control (NC) right-handed males videotaped while expressing happiness and anger. Perceivers rated the facial expressions for asymmetry in original and reversed orientations. Overall, expressions viewed in the reversed orientation were rated as more left-sided than in the original orientation. In the reversed orientation, the more extensive left hemiface of the NCs and LBDs fell in the perceiver's left hemispace. This finding is consistent with previous research demonstrating a left hemispace bias for free-field viewing of emotional faces. Expressions were produced significantly more intensely on the left than the right hemiface by NCs and LBDs; expressions of RBDs were not significantly lateralized.

Adult↗
PubMed1990

Panic disorder in cardiology patients.

This paper reviews current evidence from several cardiology populations that suggests panic disorder is prevalent and underdiagnosed. Cardiology patients with atypical angina and no heart disease have a high likelihood of having panic disorder as suggested by studies of two separate cardiology populations. That they resemble psychiatric populations with panic is suggested by their positive response to alprazolam. Although evidence is less clear concerning the relationship between MVP and panic, it appears that patients referred to ECHO and found to have MVP are also likely to have panic. Three other populations deserving further study are patients with 1) pacemaker syndrome, 2) coronary artery disease with atypical angina and 3) certain arrhythmias.

Adult↗
PubMed1990

A double-blind, placebo-controlled study of adjunctive nadolol in the management of violent psychiatric patients.

We report a controlled 3-week study (n = 30) of adjunctive use of nadolol, 80 to 120 mg per day, vs. placebo for the management of violent psychiatric patients. There were no remarkable adverse cardiac effects at this dose. The active treatment group showed lower total Brief Psychiatric Rating Scale (BPRS) scores after the first week of treatment (analysis of covariance [ANCOVA], p less than .08) and similar trends for the activation factor and the hostility scale. There were parallel findings for measures of extrapyramidal symptoms (EPS) (Simpson-Angus Neurological Rating Scale), which were reliable after the second week (ANCOVA, p less than .02). A significant association between changes in EPS and BPRS scores was found by regression analysis, after the effects of baseline measures were removed. Given that nadolol does not penetrate the central nervous system well, the antiaggressive effects may be associated with sympathetic nervous system feedback mechanisms.

Adult↗
PubMed1989

A preliminary comparison of flat affect schizophrenics and brain-damaged patients on measures of affective processing.

Flat affect is a major component of schizophrenia and is often also seen in neurological disorders. A preliminary set of comparisons were conducted to delineate neuropsychological mechanisms underlying flat affect in schizophrenia, and new measures are described for the assessment of affective deficits in clinical populations. Subjects were schizophrenic with flat affect (SZs), right brain-damaged (RBD), Parkinson's Disease (PDs), and normal control (NC) right-handed adults. Subjects were administered affective measures of expression and perception in both facial and vocal channels. For both perceptual and expressive tasks the SZs performed significantly less accurately than the NCs and the PDs but did not differ from the RBDs. This was the case for both face and voice. This finding lends support to the speculation that right hemisphere mechanisms, especially cortical ones, may be compromised among schizophrenics with flat affect.

Adult↗
PubMed1989

The 20 questions task with families of schizophrenics: divergent findings.

The study attempted to replicate and extend the results of an earlier study by Wild and Shapiro (16), establishing the utility of Mosher and Hornsby's (8) 20 Questions Task as a means of differentiating families with schizophrenic patients from those of psychiatrically hospitalized but nonschizophrenic individuals. In the current study, Wild and Shapiro's original design was expanded and revised by (a) diagnosing patients using Research Diagnostic Criteria rather than hospital diagnoses and (b) including families with schizophrenic daughters and/or one-parent families, in addition to intact families with schizophrenic sons. Families were comparable on age, intelligence, and socioeconomic variables. The results failed to replicate those reported by Wild and Shapiro, and indicated that the 20 Questions Task was sensitive to differences in family constellation and offspring gender as well as offspring diagnosis. The findings suggest that forms of familial communication deviance detected with the 20 Questions Task may not be unique to families of schizophrenics, thus highlighting the need to expand research on family communication deviance in families with schizophrenic offspring to families with varied family constellations and characteristics.

Attention↗
PubMed1989

Atypical angina in patients with coronary artery disease suggests panic disorder.

The occurrence of psychiatric disorders in patients with "medical" problems is not only possible but may be even facilitated by these problems. This article examines the relationship between the type of chest pain and the diagnosis of panic disorder among coronary artery disease (CAD) patients. Forty-nine such cardiology patients were interviewed using a structured instrument. Forty percent of patients with atypical angina met DSM-III-R criteria for current panic disorder while no panic disorder was identified in the typical angina group. This finding should have great implications for the care of CAD patients. At least many of the atypical angina patients could benefit from standard effective treatment for panic disorder. This would likely improve their functioning and decrease the financial burden on them and the health care system.

Adult↗