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Biomedical subjects

R K Pitman

Publications and source records attributed to R K Pitman.

At least 91 records · Page 5Linked to original sources

Ethological study of facial behavior in nonparanoid and paranoid schizophrenic patients.

This investigation addressed the question of affective disturbance in schizophrenia by applying quantitative measurement techniques to patients' facial behavior. The subjects were medication-free male inpatients: nine nonparanoid and six paranoid schizophrenic patients and 12 drug- or alcohol-abuse rehabilitation control patients. Two judges scored the subjects' behavior, which was recorded on videotape, according to a system that included 16 different types of facial movements. Eye blinks, eye contact, and words spoken were also scored. Compared to the control patients, the nonparanoid schizophrenic patients spoke significantly fewer words and had significantly less eye contact, while the paranoid schizophrenic patients had significantly fewer eyebrow and lower facial movements.

Adult↗

Clinical comparison of Tourette's disorder and obsessive-compulsive disorder.

The authors report on 16 outpatients with Tourette's disorder, 16 outpatients with obsessive-compulsive disorder, and 16 normal control subjects who underwent structured interviews and psychological testing. Previous findings of a high incidence of obsessive-compulsive disorder in patients with Tourette's disorder were confirmed. There was a significantly greater incidence of tics in the patients with obsessive-compulsive disorder and their relatives. Both patient groups had high rates of unipolar depressive and generalized anxiety disorders. Panic and phobic disorders were frequent in the patients with obsessive-compulsive disorder but not in the patients with Tourette's disorder. The patients with obsessive-compulsive disorder showed less coprolalia, echo phenomena, self-destructive behavior, and childhood attention deficit.

Adult↗

Janet's Obsessions and Psychasthenia: a synopsis.

Pierre Janet's Lés Obsessions et la Psychasthénie, Vol. 1 (1903) still stands as the most authoritative work on obsessional and related disorders yet written, but it remains unavailable to an English readership. This article presents an English synopsis of the French original. Janet considers the central problem to be a special mental state which he terms psychasthenia, entailing low psychological tension and an impotence of adaptation to reality. Especially affected are the reality functions of attention, volition, and present-related emotion. Their failure leads through diversion of mental energy to the forced agitations, i.e., mental manias, ruminations, tics, phobias, and anxiety. Obsessions are a late and variable development, when present they symbolize the underlying mental state of incompleteness. The full significance of Janet's contribution may have yet to be established by developments in the neurosciences.

Asthenia↗

Sustained improvement in tardive dyskinesia with diazepam: indirect evidence for corticolimbic involvement.

A rater-bind, ABA's design study of 21 cases indicates that diazepam significantly improves tardive dyskinesia and that some of the improvement persists for an extended period after diazepam is withdrawn. Since benzodiazepine receptors and sites of action seem to be mainly in the neocortex (especially frontal), limbic cortex, and deep limbs nuclei, and these structures provide most of the input into the nigrostriatopallidal system that probably regulates its role in voluntary movement, it may be suggested that impaired corticolimbic control of basal ganglia may be a factor in the pathogenesis of tardive dyskinesia.

Adult↗

Eye-head synkinesia in schizophrenic adults during a repetitive visual search task.

This study investigated the role of head movements in the functional visual field of three groups of schizophrenics and a normal control group during the performance of a repetitive visual search task. The experimental apparatus consisted of a semicircular panel with six columns of lights extending up to 90 degrees to the right of the subject's initial visual fixation point. The task involved identifying which column contained an extra light by pressing the appropriate response key. A string connected to a potentiometer measured head movements. All schizophrenic groups showed an excess of head movements in comparison to controls, reflecting abnormal coupling of head and eye movements. These results confirm previous anecdotal reports in schizophrenic adults and extend findings in schizophrenic children, which have been interpreted as reflecting maturational lag of the nervous system.

Adolescent↗

Diazepam-induced changes in tardive dyskinesia: suggestions for a new conceptual model.

Using an ABA' research design, the effects of a benzodiazepine gamma-aminobutyric acid (GABA)-ergic agent, diazepam, on various aspects of tardive dyskinesia (TD) were investigated in 21 patients. Videotaped recordings of the examinations were rated blind on the Abnormal Involuntary Movements Scale. In nonsedating amounts, diazepam had a significant anti-TD effect, especially in terms of limb dyskinesia. A significant portion of the therapeutic effect persisted after the medication was withdrawn. The results suggest that diazepam has a specific anti-TD action and that in some cases it may be able to produce a somewhat lasting correction of the deranged neurobiological mechanisms in TD. Since the main sites of action of benzodiazepines and the highest concentrations of benzodiazepine-linked GABA receptors are in the limbic and cortical structures that provide principal sources of inputs to the basal ganglia, it is suggested that the supra-striato-pallidal mechanisms of voluntary movement control should be considered in understanding the pathogenesis and treatment of TD.

Adult↗

Aggression control and structuring of social relations among recently admitted schizophrenics.

As part of a study using an ethological conceptual approach, three scales were constructed to reflect adaptive success in the structuring of social relations. Twenty recently admitted schizophrenics were studied longitudinally in an active therapeutic milieu, drug-free, and during neuroleptic treatment. Patients showed substantial failures in the ritualization of agonistic behavior, manifest in more overt flight and fight. Poor group integration and absence of bond formation characterized the sample and were correlated with social withdrawal and elevated resting pulse rate--a pattern highly reminiscent of that seen in monkeys after bilateral amygdalectomy. The paranoid subgroup was the least impaired. Four-month long intensive treatment, including neuroleptics and psychosocial therapies, produced significant but modest improvements. Considerable maladaptive functioning remained.

Adaptation, Psychological↗

Somatization disorder (Briquet's syndrome) in a male veteran.

The authors present here a case of somatization disorder in a heterosexual male veteran. The age at onset of 7 years is the earliest yet reported in a male. Extensive medical records provide a unique opportunity to follow the course of a relatively severe case of this condition and demonstrate that it fulfills the most rigorous diagnostic criteria that have been formulated. Yet, the case of Orville N is more than a lengthy list of medically unexplained symptoms, showing as it does a number of other features traditionally associated with the broad category of hysterical psychopathology.

Humans↗

Territorial behavior of schizophrenics. A phylogenetic approach.

Utilizing Tinbergen's concept of increasing phenotypic adjustability on the evolutionary scale leading to man and the ethological concept of territoriality, five Territorial Behavior Scales were designed to reflect increasing levels of adaptive behavior in humans. Twenty recently admitted schizophrenics were studied in an active therapeutic milieu during 2 drug-free weeks, followed by 14 weeks of neuroleptic treatment. Four trained raters scored each patient weekly from 0 to 3 on each scale. Ward nursing staff independently rated social behavior and obtained measures reflecting psychomotor activation and autonomic arousal. Two major types of maladaptive behaviors were identified. The first, involving a breakdown of the ability to make any territorial distinctions in structuring social relationships, correlated directly with psychomotor activation as well as autonomic arousal and was a labile, i.e., treatment-responsive, behavior. The second, involving restrictive territoriality in which the individual occupies physical space to the exclusion of social interactions with others, was unrelated to autonomic arousal but correlated inversely with psychomotor activation and was a stable, i.e., treatment-resistant, behavior. Restrictive territoriality most characterized the total group throughout the study. Adaptive territorial behaviors expected in healthy humans were rare. Following treatment, hebephrenics showed the least favorable overall territorial profile. Untreated catatonics showed the highest levels of undifferentiated or chaotic territorial behavior, but with treatment their profile approached that of the paranoids, who were the least impaired. The data support the concept that two distinct pathological processes are involved in schizophrenia and that the three diagnostic subtypes of this syndrome are meaningful clinicopathological entities.

Adult↗

Seeking the source of emotional Stroop interference effects in PTSD: a study of P3s to traumatic words.

We investigated the source of emotional Stroop interference effects in posttraumatic stress disorder (PTSD) by measuring reaction times and P3 latencies and amplitudes to personal traumatic, personal positive, and neutral words in a modified Stroop paradigm. Individuals with PTSD were slower to indicate word color, especially for traumatic words, thereby replicating emotional Stroop interference in PTSD. Individuals with PTSD also had significantly reduced and delayed P3 components across word types. Across diagnostic groups, frontal P3 amplitudes were larger to personal positive and traumatic words compared to standard neutral words. However, the absence of Diagnosis x Word Type interactions for P3 measures suggests that individuals with PTSD do not differ from individuals without PTSD in the encoding and recognition of the color of traumatic relative to nontraumatic words, and that Stroop interference does not occur during these early stages of processing.

Adult↗