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Biomedical subjects

N McConaghy

Publications and source records attributed to N McConaghy.

At least 19 recordsLinked to original sources
PubMed1992

P300 and conceptual loosening in normals: an event-related potential correlate of "thought disorder?".

Reduced amplitude of the P300 component of the event-related potential (ERP) has frequently been reported in schizophrenic patients and their first-degree relatives. The present study examined the relationship between this ERP measure of attentional processing and loosening of associations in normal university students (termed "allusive thinking"). Among male subjects, scores reflecting increased conceptual loosening, measured using the Lovibond scoring method for the Goldstein-Scheerer Object Sorting Test (OST), were significantly correlated with smaller P300 amplitude recorded during an auditory target detection task. There was no association between OST score and either performance of the target detection task or self-reported psychopathology. It is suggested that reduced P300 amplitude could reflect altered attentional processing in individuals with a constitutional trait factor of thought disorder.

Adolescent↗
PubMed1992

The relationship between relative's Expressed Emotion and schizophrenic relapse: an Australian replication.

We report a predictive study, carried out in Sydney Australia, investigating the association between the Expressed Emotion (EE) status of the household to which the patient is discharged and schizophrenic relapse. Expressed Emotion was not related to illness severity either at admission or discharge, but was related to variables reflecting chronicity and employment history. There was a significant association between returning to a high EE household and both re-hospitalisation and relapse. The significant association between EE and relapse held only for: patients not on medication, males, and those patients in high contact with their relatives. A discriminant function analysis found that decline in occupational status and the number of critical comments expressed by the relative were the strongest predictors of relapse. The results presented here are consistent with the majority of published reports on EE and relapse and contradict the negative findings of a recently published but smaller study also carried out in Sydney.

Adult↗
PubMed1992

The Sydney intervention trial: a controlled trial of relatives' counselling to reduce schizophrenic relapse.

The result of a psychosocial intervention which aimed to reduce schizophrenic relapse through relatives' counselling is presented. Thirty-six schizophrenic patients living in high Expressed Emotion (EE) parental households were randomly allocated to an intervention or control group. The parents of patients allocated to the intervention were offered ten weekly sessions of counselling. The patient was not included in these sessions. Patients in both groups received standard after-care of medication and support. Relapses in the intervention group, although fewer, were not significantly different from the control group. Given the impressive evidence in favour of family interventions in reducing relapse rates in schizophrenic patients possible reasons for this result are discussed. Aspects of the intervention described here, exclusion of the patient, no control over the patients' medication or involvement with their management, short duration of intervention and lack of individual assessment, could explain this finding. This negative result is important in indicating what factors should be included in an effective psychosocial intervention.

Adult↗
PubMed1992

Do sex-linked behaviors in children influence relationships with their parents?

When relationships are found between parents' and children's behaviors it is usually assumed the parents' behaviors produced those of the children. Forty-four young adult males and 36 young adult females reported the degree to which they showed various sex-linked behaviors and feelings of same versus opposite sex identity in childhood, and adolescence, and currently. These behaviors accounted for up to 57% of the variance of measures of the quality of relationships with parents. In men, opposite-sex-linked behaviors and identity correlated most strongly with current negative parental and particularly paternal relationships. They also correlated strongly with negative paternal relationships in childhood. Some sex-linked behaviors and sex identity items in men correlated positively with maternal overprotection in childhood and adolescence. Correlations between women's sex-linked behaviors and sexual identity items and their parental relationships were weaker but more consistently negative. As in men, opposite-sex-linked behaviors and identity in women correlated most strongly with current negative paternal relationships. The pattern of the associations and the finding that many opposite-sex-linked behaviors in subjects' childhood correlated most strongly with negative parental relationships in early adult life suggest that the parents' feelings could be partly a response to, rather than totally causal of, the subjects' sex-linked behaviors.

Adult↗
PubMed1991

The assessment and management of obsessive-compulsive disorder.

This article describes obsessive-compulsive disorder (OCD) and discusses its diagnosis and its management by behavioural therapy combined with antidepressant medication. Patients with OCD experience recurrent distressing thoughts which may lead them to avoid certain situations and to carry out protective rituals. Behavioural treatment is considered specific. The therapist establishes a relationship with the patient by which he or she can be motivated to cease the thoughts and the avoidance and ritual behaviour. The patient's family can play an important role in the therapy. The treatment is usually easier if the patient can accept taking clomipramine. Patients who, despite severe symptoms, are able to carry out their normal activities usually respond well to treatment. Those who cannot tolerate stress and have had to cease most of their normal activities usually do not respond well and require supportive therapy.

Antidepressive Agents↗
PubMed1991

A comparison of relapsed and non-relapsed abstinent pathological gamblers following behavioural treatment.

Eighteen pathological gamblers reporting abstinence at a 2-9-year follow-up period were classified into two samples; those reporting complete abstinence, or those abstinent with intermittent relapse episodes. Results indicated that both samples improved significantly on post-treatment psychological and demographic measures, and did not differ from each other. It was concluded that a subgroup of gamblers may experience intermittent brief relapses that are not invariably associated with a continued return to addictive gambling habits. Complete abstinence as a criterion for successful treatment outcome may be too stringent in that it fails to acknowledge the possibility of continued abstinence following brief episodes of relapse.

Adult↗
PubMed1991

Control versus abstinence in the treatment of pathological gambling: a two to nine year follow-up.

A structured gambling interview schedule, the Eysenck Personality Questionnaire, Spielberger's State-Trait Anxiety Inventory, Zuckerman's Sensation Seeking Scale and Beck Depression Inventory were administered to 63 out of 120 pathological gamblers who had 5 years previously completed a behavioural treatment for uncontrollable gambling behaviour. Results indicated that both abstinence and controlled gambling outcomes were associated with continued improvement in self-report and psychological indices of social functioning and psychopathology. Response to treatment was associated with a reduction in arousal levels, anxiety and depression. Uncontrolled gamblers failed to show post-treatment changes on parameters of improvement. It was concluded that abstinence is not the only possible therapeutic outcome in behavioural treatment and further, that controlled gambling is not a temporary response which is followed by a return to continued uncontrollable gambling.

Adult↗
PubMed1991

The effect of repeated testing on ERP components during auditory selective attention.

The present study examined long-term repetition effects on human auditory event-related potentials (ERPs). ERPs were recorded from subjects performing the same multidimensional auditory selective attention task on six separate occasions spaced one week apart. The task required subjects to attend to tones that varied along the dimensions of location (L), pitch (P), and duration (D) and to detect prespecified target (L + P + D +) combinations of these attributes. Processing negativity (PN) between 100-400 ms did not change in amplitude or onset latency as a function of repeated experience with the task. In contrast, two measures of "very late" PN were reduced with practice. Specifically, the location effect measured over the 400-700-ms epoch was significant only for Weeks 1 and 2, and the separation of the L + P + D- ERP from other D- ERPs, measured over the 700-1000-ms epoch, was significantly reduced from Week 1 to Week 2. A late negative component (700-1000 ms) elicited by correctly identified targets increased between Weeks 1 and 2, consistent with subjects adopting the strategy of rehearsal of the target itself rather than the L + P + D- standard. P2 amplitude increased significantly for all standards, possibly due to decreased latency jitter in later weeks. N1 latency became significantly shorter over weeks, reflecting either increasing confidence in stimulus discrimination with repeated testing or the overlapping of an unchanging N1 with an increasing P2.

Acoustic Stimulation↗
PubMed1991

Effects of inter-item lag on word repetition: an event-related potential study.

Prior exposure to a word can greatly facilitate performance to subsequent presentations of that word. ERP studies have shown that this facilitation is associated with an attenuation of a negative peak normally occurring around 400 ms poststimulus. Recent studies have interpreted this repetition effect as reflecting either lexical access or episodic memory mechanisms. However, there is now increasing evidence that neither of the above mechanisms alone can fully account for repetition effects. The present experiment recorded ERPs to immediate and delayed word repetition during a lexical decision task in order to investigate the time-course of ERP repetition effects. Immediate repetition was found to produce greater response facilitation than delayed repetition. The ERP waveforms of both immediate and delayed word repetition diverged from that of initial word presentation at approximately 300 ms poststimulus. The waveforms for repeated words separated around 400 ms poststimulus with immediate repetition showing a more rapid resolution of negativity and earlier late positivity than delayed repetition. It is suggested that the negativity may reflect processes involved in the overall activation contributing to word recognition, whereas the late positivity may be related to the repetition of stimulus categorization and decision processes.

Adult↗
PubMed1991

Auditory selective attention and event-related potentials in schizophrenia.

Brain ERPs were recorded in ten unmedicated schizophrenic patients and age- and sex-matched healthy controls during a multidimensional listening task. Patients showed a marked reduction in a long-duration attention-related negative ERP component, termed 'processing negativity' (PN), which was elicited by attended stimuli. The amplitude of PN was significantly correlated with SANS and SAPS scores of schizophrenic symptoms. The P300 component was also reduced in amplitude in patients, and was significantly correlated with SANS ratings of negative thought disorder. These findings provide neurophysiological evidence of impairment in the maintenance of selective attention and the cognitive processes associated with target detection among schizophrenic patients. The reduced PN in schizophrenics implicates frontostriatal pathways in the aetiology of attentional deficits in schizophrenia.

Adult↗
PubMed1991

Comparison of imaginal desensitisation with other behavioural treatments of pathological gambling. A two- to nine-year follow-up.

Of 120 pathological gamblers randomly allocated to imaginal desensitisation (ID) or to other behavioural procedures (60 to each group, all procedures administered over one week) 63 subjects were contacted two to nine years later. Twenty-six of the 33 who received ID reported control or cessation of gambling compared with 16 of 30 who received other behavioural procedures. This difference was significant, indicating ID had a specific effect additional to that of the other behavioural procedures. It is suggested the other procedures could be regarded as placebos. As the response at a mean of over five years to one week of ID is comparable with that reported to more intensive therapies, after briefer follow-up, it is suggested ID is a cost-effective therapy for pathological gambling, and is worth considering when resources are limited.

Aversive Therapy↗
PubMed1991

Opposite sex behaviours correlate with degree of homosexual feelings in the predominantly heterosexual.

There is extensive evidence that subjects who identify as homosexual show opposite sex-linked behaviours. However no attempt has been made to investigate whether a similar association exists between such behaviours and the presence of homosexual feelings in the predominantly heterosexual. Eighty medical students completed an anonymous questionnaire reporting the ratio of their heterosexual to homosexual feelings and the presence of sex-linked behaviours in their earlier life and currently. As in previous studies correlations between opposite sex behaviours and subjects' degree of homosexual feelings were found in the male subjects. Correlations remained present, though mainly at a weaker level, in the predominantly heterosexual students. It is suggested this evidence of a dimensional relationship between opposite sex-linked behaviours in childhood and degree of homosexual feeling in adulthood renders irrational the classification of such behaviours as a gender identity disorder of childhood when homosexuality in adults is not regarded as a disorder.

Adult↗
PubMed1990

Event-related potential indices of selective attention and cortical lateralization in schizophrenia.

Auditory event-related potentials (ERPs) from a multidimensional selective attention task were recorded from 10 unmedicated schizophrenic patients and 10 age- and sex-matched healthy controls. Tone pip stimuli varying on the dimensions of pitch (high or low) and location (left or right ear) formed four 'channels' of stimuli: left low, left high, right low, and right high. The pitch difference was considerably more difficult to discriminate than the location difference. Subjects were instructed to pay attention to a designated channel and press a button whenever they detected a long-duration, rare target tone that occurred amongst frequent short-duration standard tones. There were a number of differences between unmedicated schizophrenics and controls in processing negativity elicited by standard tones. There was no evidence of hierarchical processing of stimulus dimensions in the early processing negativity component, and the late frontal component was virtually absent in schizophrenics. Furthermore, there was evidence that in schizophrenics the processing of the location dimension was delayed for standard tones having the same pitch as the target. The P300 component to attended target tones was substantially reduced in schizophrenics over parietal sites but there was no difference between the two groups over frontal sites. The results are interpreted in terms of multiple attentional deficits in schizophrenics that are indicative of a failure in the planning and execution of selective listening strategies. Such a failure may result from a dysfunction in the prefrontal regions of the brain.

Adult↗
PubMed1990

Boredom proneness in pathological gambling.

To test the hypothesis that pathological gamblers seek stimulation as a means of reducing aversive under-aroused states of boredom and/or depression, the Beck Depression Inventory, Zuckerman's Sensation Seeking Scale and a Boredom Proneness Scale were administered to 48 diagnosed pathological gamblers and a control group of 40 family physician patients. Analyses of variance showed pathological gamblers obtained significantly higher boredom proneness and depression scores than those of controls. That the Boredom Proneness Scale failed to correlate with the Zuckerman Boredom Susceptibility subscale suggested the two measure differing dimensions. Results indicated the possible existence of three subtypes of pathological gamblers, one group characterized by boredom, another by depression, and a third by a mixture of both depression and boredom.

Adult↗
PubMed1990

Assessment and treatment of sex offenders: the Prince of Wales Programme.

The treatment programme for sex offenders at the Prince of Wales Hospital, Sydney, is described. Penile circumference assessment is not used as there is no evidence it provides a valid measure of individuals' paedophile or rapist tendencies. Sex offenders' self-reports remain the major source of information in their assessment. The development of the two major techniques used--imaginal desensitization and short-term medroxyprogesterone--is outlined. About 80% of subjects can be expected to show a good response to one or other of these therapies. Of those who do not, most respond to the alternative or aversive therapy. Adolescent offenders appear to require more intensive treatment. Results appear comparable with those of more intensive programmes in use overseas.

Adolescent↗
PubMed1990

Can reliance be placed on a single meta-analysis?

Meta-analysis replaced statistical significance with effect size in the hope of resolving controversy concerning evaluation of treatment effects. Statistical significance measured reliability of the effect of treatment, not its efficacy. It was strongly influenced by the number of subjects investigated. Effect size as assessed originally, eliminated this influence but by standardizing the size of the treatment effect could distort it. Meta-analyses which combine the results of studies which employ different subject types, outcome measures, treatment aims, no-treatment rather than placebo controls or therapists with varying experience can be misleading. To ensure discussion of these variables meta-analyses should be used as an aid rather than a substitute for literature review. While meta-analyses produce contradictory findings, it seems unwise to rely on the conclusions of an individual analysis. Their consistent finding that placebo treatments obtain markedly higher effect sizes than no treatment hopefully will render the use of untreated control groups obsolete.

Bias↗
PubMed1989

Validity and ethics of penile circumference measures of sexual arousal: a critical review.

Wheeler and Rubin (1987) advanced evidence that penile volume responses (PVRs) were no more sensitive than penile circumference responses (PCRs) in measuring erection which the authors incorrectly identified with sexual arousal. Knowledge of the literature would have led them to question that identification and the methodology of their study. PVRs have repeatedly been demonstrated to assess validly not erection but the sexual orientation of individuals, when derived from the early stage of erectile response to brief stimuli that were from their onset of moderate erotic strength. PCR assessment has been of the degree of erection to stimuli of 2-10 min duration. No success has been reported using PCR measures of erection to classify subjects individually as to their sexual orientation. Classification of groups of 30 but not 6 homosexuals was successful using their PCRs to nudes. Attempts to identify rapists and pedophiles from normals, and aggressive from nonaggressive rapists and pedophiles by PCRs have failed to be replicated. In comparing PVRs and PCRs, Wheeler and Rubin used as stimuli three 10-min presentations of a film which apparently did not immediately introduce erotic material. This procedure would not elicit meaningful PVRs. Though never validated as a measure of individuals' sexual arousal, PCR measures of erection are currently widely recommended for assessment and determining treatment of individual sex offenders. If these assessments could affect or are believed by the offenders to affect the outcome of the legal processes in which they are involved, the procedure is not only scientifically unsupported, it is unethical.

Arousal↗