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Biomedical subjects

S R Kay

Publications and source records attributed to S R Kay.

At least 91 records · Page 5Linked to original sources
PubMed1982

Conceptual disorder in schizophrenia as a function of encoding orientation.

This study evaluated the hypothesis that schizophrenic conceptual disorder derives from abnormal verbal encoding, geared to salient affective and physical cues at the expense of conceptual attributes. Subjects were 63 adult psychotic inpatients, including 42 schizophrenics and 21 nonschizophrenics of similar age, sex, race, and chronicity. They underwent 12 trials on Wickens' release from proactive interference (PI) procedure to measure reliance on three dimensions for encoding: conceptual (taxonomic class), affective (Evaluation axis of the semantic differential), and physical (rhyming sounds). The release effect for schizophrenics, compared with controls, was found to be significantly weaker on the conceptual dimension and correspondingly stronger on the affective dimension. Whereas controls exhibited the normal attraction to conceptual over other cues, schizophrenics presented a flat profile. Nonparanoid and thought-disordered schizophrenics showed particular deficits on the conceptual dimension. All schizophrenic groups contrasted controls by their diminished PI release with less salient concepts. The results thus suggested that encoding by schizophrenics is uniquely oriented to stimulus salience rather than semantic relevance. A fundamental deficiency in processing of cues essential for conceptual operations, accordingly, seems to underlie the conceptual dysfunction in schizophrenia. The implications were discussed in relation to diversities in the cognitive literature and prevalent theories.

Adult↗
PubMed1981

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↗
PubMed1981

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↗
PubMed1981

Neural influences on experimental flap survival.

We have constructed a consistent, reproducible experimental model for the study of skin flap survival consisting of paired flaps that are identical except for the presence or absence of innervation. While the denervated flap survived to only 70 percent of its original length, the innervated flap survived completely in all cases. We then studied the effect of adrenergic innervation on flap survival by performing a chemical sympathectomy using 6-hydroxydopamine. We observed that loss of sympathetic innervation, as measured by absence of piloerection and catecholamine fluorescent staining, resulted in flap necrosis even in the presence of intact somatic and sensory function. We have concluded that the observed differences in survival between the innervated and denervated flaps appear to be dependent at least in part of the presence or absence of noradrenergic regulation of the microcirculation within the flaps.

Animals↗
PubMed1981

Disjunctive arousal changes as a consequence of nondrug clinical intervention.

Sleeplessness and resting pulse rate were studied in relation to behavioral treatment of 34 chronic psychotics using an 18-week ABAB research design. These arousal measures, unrelated in the base line, showed significant opposing changes during four of the first ten treatment weeks. Sleeplessness improved proportionately with clinical response, gauged by social participation, whereas pulse rates were significantly exacerbated early in treatment. When treatment was withdrawn and reinstated, pulse rates correspondingly decreased and increased significantly. These results suggested that arousal changes transcend specific drug action and are a consequence of treatment -- possibly a hindrance -- rather than its source. The systematic differences supported a distinction between two arousal processes, on responsive and one resistant to treatment. It was proposed that the elevation of autonomic arousal with treatment may reflect dysphoria from threat to psychotic homeostasis and consequent therapeutic resistance. Implications were drawn regarding clinical intervention with poor prognosis psychotics, a two-factor model of arousal disorder, and a nonunitary approach to arousal research.

Adult↗
PubMed1980

Progressive Figure drawings in the developmental assessment of mentally retarded psychotics.

A Progressive Figure Drawing Test was assembled to delineate level of perceptual-motor development in patients with both developmental and psychiatric disorders. 63 mentally retarded psychotic adults were evaluated by this procedure and other measures of intellectual, social, and psychiatric functioning. The test's reliability and developmental hierarchy were supported, and significant differentiation among grades of retardation was noted. Strong correlates were obtained with the other developmentally based tests while its associations with indices of psychosis were significantly weaker or inconsequential. The findings suggested that this procedure may separate cognitive subnormality from abnormality related to psychosis. It was proposed that developmental assessment may provide a crucial perspective for clinical evaluation and research into mental retardation and psychosis.

Adult↗
PubMed1979

Therapeutic antagonism between anticholinergic antiparkinsonism agents and neuroleptics in schizophrenia. Implications for a neuropharmacological model.

Systematic data from three studies suggest that anticholinergic antiparkinsonism agents, when added to ongoing neuroleptic treatment in schizophrenics, have the effect of arresting or reversing therapeutic changes, and when given alone to untreated patients, tend to further worsen their psychosis. The countertherapeutic effects of anticholinergic drugs are reflected particularly in parameters which represent features of schizophrenic psychosis most consistently responsive to neuroleptics. It is proposed that these anticholinergic effects are central in origin and point to the involvement of cholinergic mechanisms in the expression of schizophrenic psychosis and its improvement with neuroleptic medication.

Antiparkinson Agents↗
PubMed1979

Schizophrenic WAIS pattern by diagnostic subtypes.

Post-treatment WAIS scores of 36 hospitalized schizophrenics were analyzed according to diagnostic subdivisions elsewhere validated. Significant differences emerged between Verbal and Performance Scales and among the 11 subtests, which transcended diagnostic subclasses. The results implied a reliable schizophrenic WAIS pattern supportive of Wechsler's (1958) proposal.

Adolescent↗
PubMed1979

Dysphoric response to neuroleptic treatment in schizophrenia: its relationship to autonomic arousal and prognosis.

Longitudinal pharmacotherapeutic data from 58 schizophrenic patients suggest that the emergence of a dysphoric state, characterized by a combination of anxiety, depression, and accusatoriness, early in the course of neuroleptic treatment augurs poor therapeutic outcome and is associated with an unfavorable prognostic classification and a tendency for autonomic arousal to increase with treatment from a drug-free base line somewhat higher than normal. These associations particularly characterized the nonparanoid schizophrenics with nuclear prognostic classification and poor short-term as well as long-term therapeutic outcome; they did not apply to the paranoids. The dysphoric response was unrelated to base-line dysphoria or to the extrapyramidal reactions to neuroleptic medication, and seemed to reflect some basic biological differences between the poor prognosis nonparanoid, the good prognosis nonparanoid, and the paranoid schizophrenics.

Adult↗
PubMed1978

Therapeutic antagonism between anticholinergics and neuroleptics: possible involvement of cholinergic mechanisms in schizophrenia.

We have answered technical criticisms of our work in which anticholinergic agents were added to ongoing neuroleptic treatment in an ABA' research design. The suggested analysis of variance for repeated measures of the three periods is inappropriate because of the expected carryover effects from continuous neuroleptic treatment. The multivariate analysis of various parameters seems unsuitable because homogeneity of covariance cannot be ensured due to the heterogeneity of schizophrenia and the diverse factors represented in the psychopathology measures. We have summarized the results of recent parametric and nonparametric analyses of combined data from our three studies to show that the significant effects clearly pointed to therapeutic antagonism between anticholinergic agents and neuroleptics. We suggest that cholinergic neurons may be part of some crucial discriminative control mechanisms in the brain organization that are ineffective in schizophrenia and lead to a relative overactivity of the opposing catecholaminergic neurons in the midbrain-limbic circuitry which promote repetition of behaviors in goal-directed activity.

Antipsychotic Agents↗
PubMed1978

Nosological and prognostic distinctions in schizophrenia: pharmacological validation in terms of therapeutic antagonism between anticholinergic anti-parkinsonism drugs and neuroleptics.

In studying the relationships between anticholinergic-neuroleptic interactions and the nosological and prognostic distinctions in schizophrenia, we have shown that these distinctions have clinicopathological meaning. The countertherapeutic anticholinergic effects seemed to be particularly evident in the good outcome, schizophreniform cases and differentiated between the three diagnostic subtypes. Such effects were most conspicuous in the catatonics who also had the most favorable prognosis, while the paranoids differed from others in not only showing the least anticholinergic effects but also in not conforming to the relationship between these effects and prognosis. The findings are briefly considered in relation to those with wheat gluten which has also been shown to be a countertherapeutic factor in schizophrenia in another study.

Acute Disease↗
PubMed1978

Qualitative differences in human figure drawings according to schizophrenic subtype.

Human figure drawings were obtained from 136 adult schizophrenics, of whom 63 were mentally retarded. The protocols were evaluated independently by three jduges for presence of 15 defined features that stressed the quality rather than specific content of the drawings. Adequate reliability and frequency were established for seven of the parameters, which were then compared for prevalence among subgroups classified by diagnosis, preognosis, chronicity, and level of retardation. Significant differences appeared for all comparisons and each of the analyzed features. The differences among non-retarded schizophrenic subgroups seemed to reflect phenomenological distinctions, while differences associated with intellectual retardation seemed to represent developmental limitations. These data supported the validity of the figure drawing technique for distinguishing among schizophrenic subtypes and underscored the importance of suitable methodology in evaluating projective measures.

Adult↗
PubMed1977

Developmental assessment of cognitive style in mentally retarded psychotics.

Evaluated 55 mentally retarded psychotic adults with the Color-Form Preference Test, a developmentally based index of cognitive style, and other measures of intellectual, social, and psychiatric functioning. Results indicated that different grades of retardation were associated with distinct cognitive styles, which showed a systematic progression that corresponded to the normal developmental sequence. In contrast, no significant relationships were observed between cognitive style and psychotic manifestations. The findings suggested that fresh insights into mental retardation and psychosis are made possible by qualitative, developmental assessment. The implications for clinical application, theory formulation, and research were discussed.

Adolescent↗
PubMed1976

Wheat gluten as a pathogenic factor in schizophrenia.

Schizophrenics maintained on a cereal grain-free and milk-free diet and receiving optimal treatment with neuropleptics showed an interruption or reversal of their therapeutic progress during a period of "blind" wheat gluten challenge. The exacerbation of the disease process was not due to variations in neuroleptic doses. After termination of the gluten challenge, the course of improvement was reinstated. The observed effects seemed to be due to a primary schizophrenia-promoting effect of wheat gluten.

Adult↗