PubMed · 4255242
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J I Williams. 1971. Disease as deviance.. https://doi.org/10.1016/0037-7856(71)90074-6
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Congestive heart failure (CHF) is the end stage of many diseases of the heart and a major cause of morbidity and mortality. The incidence of CHF is increasing steadily as treatment for its coronary antecedents, such as myocardial infarction, advances. Treatment of CHF generally relies on a battery of pharmacological interventions, alongside exercise and diet regimens. It is only in recent years that the psychological impact of heart failure has been explored, which is reflected by the absence of standardized psychological assessment for patients with CHF. In this article, we review studies that have addressed the effects of depression, anxiety, coping style, and level of social support in CHF. From the available evidence, it appears that patients generally experience moderate levels of depression, but not greatly heightened anxiety. Level of social support and style of coping with the disease are, however, important prognostic factors. It is difficult to draw definitive conclusions owing to the paucity of literature. Further work examining this issue is needed if the psychological issues of heart failure are not to be neglected.
This study examines problem behavior over time in 59 boys with fragile X syndrome (FXS), aged 4-12 years, using the Child Behavior Checklist (CBCL). Approximately 49% of the boys scored within the borderline or clinical range on total problem behavior, while 56-57% scored in the borderline or clinical range on the attention and thought problems subscales, and 26% scored in this range on the social problems subscale. With a mean of 2.5 assessments per child, behavior problems were stable during the 3-year period of study. Total problem behavior was higher for children who displayed autistic behavior, were rated as low in adaptability, had mothers with higher maternal education levels, and were on medication. Mothers with more education also rated their children as having more attention, thought, and total problems. Children taking medication differed from boys who were not taking medication on social problems, but not on attention and thought problems. Low adaptability and more autistic characteristics predicted thought problems.
Studies of arm movements have shown that subjects learn to compensate predictable mechanical perturbations by developing a representation of the relation between the state of motion of the arm and the perturbing forces. Here, we tested the hypothesis that subjects construct internal representations of two different force fields and switch between them when presented with an alternating sequence of these fields. Our results do not support this hypothesis. Subjects performed reaching movements in four sessions over 4 days. On the 1st day the robotic manipulandum perturbed the movement by perpendicular force that alternated its direction after each movement. Subjects were unable to construct the two underlying models and switch between them. On the 2nd day only one field was applied and well learned. On the 3rd day only the other field was applied and well learned. Then the experiment of the 1st day was repeated on the 4th day. Even after this extensive training subjects showed no signs of improved performance with alternating fields. This result combined with previous studies suggests that the central nervous system has a strong tendency to employ a single internal model when dealing with a sequence of perturbations.