Drug-related cognitive impairment: current progress and recurrent problems.
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Biomedical subjects
Publications and source records attributed to R L Morrison.
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The recent literature on social skills training has placed an increasing emphasis on the role of cognitive factors in social failure, as opposed to deficits in motoric skills. It has been hypothesized that schizophrenic patients are markedly deficient in social problem-solving abilities, and several programs have been developed to teach problem-solving skills. Despite high face validity, there is little empirical support for these training programs or the problem-solving model on which they are based. Research on information processing and problem solving in nonpatient populations is discussed, and it is concluded that the model used in these treatment programs is not a good representation of the problem-solving process. In particular, means-ends analysis is not an appropriate strategy for dealing with most interpersonal problems and conflicts. The difficulties experienced by schizophrenic patients in social situations might be due to a number of factors other than deficits in problem-solving skill, including sensitivity to negative affect and disordered communication. It is concluded that further research on problem-solving training programs is clearly warranted but that the validity of the problem-solving model and the utility of the training is uncertain.
It has been widely demonstrated that schizophrenic patients show a broad range of deficits in interpersonal skills. Recently, considerable attention has been focused on the ability of these patients to decode affective cues. This article reviews findings about facial-affect recognition in schizophrenia. While the literature on this topic is extensive, many investigations have suffered from significant methodological shortcomings. Strategies to resolve these shortcomings are presented. Possible relationships between problems of affect recognition and other symptoms that characterize schizophrenia are discussed. Neurological mechanisms of facial-affect recognition are reviewed and related to data on lateralized neurological impairment in schizophrenia. Suggestions for future research emphasize careful consideration of affect-recognition deficits in relation to other parameters of schizophrenia.
Social dysfunction is generally considered an essential feature of schizophrenia. However, despite considerable interest in the social functioning of schizophrenic patients, the precise nature of the social deficits exhibited by these patients remains unspecified. No widely accepted criterion of social competence has been used to investigate their social functioning. Also, social skills researchers have often failed to recognize the heterogeneity of schizophrenia and the impact that this heterogeneity may have on attempts to implement psychosocial interventions. The adverse findings regarding the social behavior of schizophrenic patients are reviewed. Factors relating to schizophrenia that may affect their social functioning are discussed, as are directions for future research that may lead to more effective psychosocial interventions for schizophrenia.
The development of acute dystonic reactions was monitored in 202 acute psychiatric patients during initial hospitalization and treatment with various neuroleptic drugs in a prospective study. Data were analyzed to determine the effect of anticholinergic prophylaxis, age, sex, and type and dosage of neuroleptic on the incidence of dystonic reactions. Nearly 90% of dystonic reactions occurred by the third day of treatment. The overall trend favored the prophylactic use of antiparkinsonian drugs with all neuroleptics, and the effect of this prophylaxis with haloperidol was statistically significant. Because anticholinergic prophylaxis was used more often when larger dosages of neuroleptics were prescribed, an added effect in the observed trend for fewer dystonic reactions is suggested.
The present study provided an assessment of alcohol use in couples characterized by wife abuse. The Michigan Alcoholism Screening Test, Quantity-Frequency Index, Impairment Index, and a questionnaire tapping frequency and magnitude of violent episodes were administered to couples who were: (a) physically abusive, (b) maritally discordant but nonviolent, and (c) satisfactorily married. Results indicated significantly higher scores on the Michigan Alcoholism Screening Test in physically abusive males based on their self-reports as well as wives' reports of husbands' drinking behavior. No significant differences were found between groups of wives on alcohol measures. In addition, correlational analyses revealed a number of significant relationships between husbands' self-reported drinking and wives' responses concerning their spouses' alcohol use. Findings are discussed in terms of the need for more extensive assessment of physically abusive males, and the utility of examining the interactive influences of alcohol and other factors on marital violence.
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A 37-year-old female with Capgras syndrome was assessed on psychometric and neuropsychological measures. Significant neuropsychological deficits suggesting a frontal-temporal cerebral dysfunction were observed. The results demonstrate that the Capgras delusion involves more than an inability to recognize faces, although this deficit is one manifestation of the disorder.
Protein supplements having either a high (soybean meal, SBM) or low (escape protein, EP) extent of ruminal N degradability with or without lasalocid (L) were evaluated in digestion and growth trials. The SBM supplement included soybean meal while EP was a combination of dehydrated alfalfa and distillers dried grains. Nitrogen digestibility of SBM supplements was consistently higher than EP supplements when evaluated with two lamb trials. Digestibility of N was improved 8% in trial one (64.9 vs 60.3%) and 27% in trial two (66.3 vs 52.3%) with SBM vs EP. The addition of L to the supplements improved N digestibility by 6% in trial one (64.5 vs 60.6%) and 13% in trial two (62.9 vs 55.7%). No interactions between protein source and L were measured in either trial. Dry matter digestibility was not changed by protein source or L in either trial. Rumen propionate was increased and acetate to propionate ratio decreased when L was fed. Plasma urea N was lower over a 24 h sampling period when lambs were fed EP supplements compared with SBM supplements (11.07 vs 16.44 mg/100 ml); however, L did not appear to consistently alter the values. When steers were supplemented with the same protein sources during a 105-d winter pasture trial daily gains were not affected (P greater than .10) by either protein source or L (.429, .495, .476 and .514 kg/d for SBM, SBM+L, EP and EP+L, respectively) although numerically there did not appear to be main effect improvements due to EP and L.(ABSTRACT TRUNCATED AT 250 WORDS)
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Social skill and role functioning were assessed in matched groups of patients with DSM-III-R schizoaffective disorder, bipolar disorder, and schizophrenia. Schizophrenics were categorized as negative syndrome or non-negative on the basis of the SANS. The negative schizophrenics were significantly more impaired on almost every measure of social functioning. The other three groups were not consistently different from one another. The results suggest that when patients are comparable on dimensions such as duration and severity of illness, schizoaffectives do not occupy an intermediate position between schizophrenics without negative syndrome and bipolar patients. Rather, the three groups exhibit similar degrees of social disability. In contrast, negative syndrome schizophrenics were more impaired even when they were similar in chronicity and severity.
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