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Effect of nicotine on quinpirole-induced checking behavior in rats: implications for obsessive-compulsive disorder.

BACKGROUND: Rats treated chronically in a large, open field with the dopamine D2/D3 receptor agonist quinpirole (QNP) develop compulsive checking behavior as defined by a set of behavioral criteria. This paradigm has been suggested as an animal model of obsessive-compulsive disorder (OCD). Because nicotine blocks various behaviors induced by ontogenetic QNP administration, we asked whether nicotine could attenuate QNP-induced compulsive checking. METHODS: Adult male Long-Evans rats (n = 14/group) were treated twice weekly with saline (control), or with QNP (0.5 mg/kg) for 14-16 injections. On the last two injections, rats were pretreated in random order with an acute dose of nicotine (0.3 mg/kg base) or saline 10 min before administration of QNP or saline; and the effects on checking behavior was examined. The effects of chronic QNP treatment on nicotinic receptors in discrete brain regions were also determined. RESULTS: Chronic QNP resulted in compulsive checking and increases in cerebellar alpha4beta2 and alpha7 nicotinic receptor densities. Nicotine pretreatment significantly reduced one of the three measures of compulsive checking behavior. CONCLUSIONS: Nicotine attenuates some symptoms of compulsive checking in a rat model of OCD; however, the mechanisms of this effect and therapeutic efficacy of nicotinic agonists in OCD require further study.

Animals↗

Behavioral treatment of childhood neurosis.

The present study attempted to use behavioral treatment to eliminate the neurotic symptoms of a 5-year-old child. The child's symptoms were assessed on a pre- and post-treatment basis, and in addition, on going observations of the child's symptoms allowed daily evaluation of the treatment program. Behavior therapy focused on altering the current symptom-environment relationships experienced by the child. Follow-ups on the resolution of the child's problems were conducted two months and two years after behavior therapy and indicated that the child was systom free. Therapeutic attempts to resolve the historical conflicts of early childhood and to resolve the contemporary corflicts of current social interaction are discussed as viable but not mutually exclusive therapeutic strategies.

Attention Deficit Disorder with Hyperactivity↗

Obsessional phenomena and the development of imaginative competence.

Obsessional phenomena are discussed in the light of anxieties arising around the ages 8-12. Three cases of the disappearance of obsessional symptoms are then described. In one remarkable sequence of dreams preceded recovery; in another it was the establishment of a secure therapeutic bond; in the third it was falling in love. The capacity securely to differentiate between fantasy and reality is seen as an essential development element in the recovery from obsessionality.

Adolescent↗

Depression, anxiety, and obsessionality in long-term recovered patients with adolescent-onset anorexia nervosa.

Anorexia nervosa (AN) is frequently associated with symptoms of depression, anxiety, and obsessive-compulsive behavior which also develop secondary to semistarvation. It is less certain if these symptoms persist after recovery. A few studies have already reported on high prevalence rates of anxious, depressive, and obsessive features in long-term recovered patients with AN, but several of these so called "long-term" recovered patients had only maintained weight restoration for six to twelve months. The aim of this study was to determine whether depressive, anxious, and obsessive-compulsive symptoms persist in truly long-term recovered patients (BMI 20.3+/-2.5 kg/m(2)) who no longer had any eating disorder symptoms (including weight phobia) for at least 3 years. Seventeen subjects of an AN sample (n=39) previously described in a 10-year follow-up met our strict criteria of at least 3 years of complete recovery of AN. In comparison to 39 age-, sex-, and occupation-matched healthy subjects without a history of psychiatric or eating disorder, long-term recovered patients had higher levels of depressive (p=0.002), anxious (p=0.006), and obsessive-compulsive (p=0.015) features but did not differ with regard to psychiatric morbidity and psychosocial adaptation. In conclusion, depressive, anxious, and obsessive-compulsive symptoms may be personality traits in subjects with former adolescent anorexia nervosa.

Adolescent↗

The treatment of autistic children.

The goals of treatment need to be decided on the basis of knowledge on the nature of autism. As with any developmental disorder, the first goal must be to foster normal development; with autistic children this involves a focus on intellectual, language and social development. The further goals include: the reduction of rigidity/stereotypy; the elimination of non-specific maladaptive behaviours; and alleviation of family distress. Research findings are used to translate these goals into a practical overall therapeutic programme with three main elements: a full diagnostic appraisal, special educational provision and a home-based programme for the family. Finally, the research findings are drawn together to derive inferences on the lessons to be learned and the questions that remain to be answered.

Autistic Disorder↗

Stalking perpetrators and psychological maltreatment of partners: anger-jealousy, attachment insecurity, need for control, and break-up context.

Two studies of the correlates of self-reported courtship persistence, stalking-like behaviors following a relationship break-up, and psychological maltreatment of partners were conducted in samples of male (N = 46 and 93) and female (N = 123 and 110) college students. Approximately 40% (38.5% and 44.6%) engaged in at least one stalking behavior following a break-up. A total of 10.7% (study 1) and 7.6% (study 2) engaged in 6 or more stalking behaviors. Stalking was significantly related to psychological maltreatment of the partner (PMP) prior to the break-up. Being the recipient of the breakup was associated with feelings of anger, jealousy and obsessiveness and with higher levels of courtship persistence, and stalking. A replicated path model showed that anxious attachment and need for control were related to PMP and that need for control had a direct contribution to stalking. For anxious attachment, its connection to stalking was indirect, mediated by the degree of anger-jealousy over the break-up.

Adult↗

Persistent preceding focal neurologic deficits in children with chronic Epstein-Barr virus encephalitis.

Epstein-Barr virus encephalitis is a self-limiting disease with few sequelae. Persistence of neurologic deficits prior to and after the acute illness has yet to be described in children. We describe five children with persistent cognitive and focal neurologic deficits due to chronic Epstein-Barr virus encephalitis with various T2-weighted magnetic resonance imaging abnormalities. Clinical features were a 9-year-old boy with aphasia and apraxia, an 11-year-old girl with impulsivity and inappropriate behavior, a 17-year-old boy with deterioration of cognitive skills and judgment, a 5-year-old boy with complex-partial seizures, and a 6-year-old girl with obsessive-compulsive behavior. All patients had elevated serum Epstein-Barr virus titers for acute infection, with cerebrospinal fluid polymerase chain reaction positive for Epstein-Barr virus in four patients. Three children were treated with methylprednisolone with minimal improvement without changes on magnetic resonance imaging. Epstein-Barr virus encephalitis can present with chronic and insidious neurologic symptoms and should be considered in the differential diagnosis of children with acute or chronic neurologic illness of unknown etiology.

Adolescent↗

Hypothesis II: Tourette's syndrome is part of a clinical spectrum that includes normal brain development.

Several lines of evidence suggest that the typically associated clinical features of Tourette's syndrome (TS), ie, tics, obsessive-compulsive behavior, inattention, and hyperactivity, commonly occur during childhood development. I hypothesize that TS is expressed in children as a clinical spectrum that includes a range of increasing functional impairment, indicating various degrees of abnormality in basal ganglia development. The mildest form, "developmental" TS, includes largely asymptomatic features and is estimated to occur in at least 3% of all children. Further along the spectrum are children with mild to moderate TS, who have school and behavioral problems; up to 25% of children requiring special education may be classified within this group. At the extreme end of the spectrum is the smallest group, patients with "full-blown" TS, characterized by more severe and often disabling symptoms. I propose that genetic influences are most important in determining the severity of TS along the clinical spectrum but that environmental factors may play a role. This hypothesis has implications for the understanding and treatment of childhood school and behavioral problems and the search for the TS genetic defect.

Attention Deficit Disorder with Hyperactivity↗

[Psychiatrists as victims of stalking].

Stalking is defined as notorious following, menacing, harassing, and contacting of a victim against his or her declared will. Such behavior can occur in a variety of psychiatric disorders. Attending physicians can also become victims of stalking. Especially psychiatrists appear to have a high risk of being stalked. Up to now, only a few studies investigated stalking behavior of patients aimed at medical professionals. In most cases, it was investigated together with aggressive behavior and sexual harassment. Cases of psychiatrists being stalked by patients or clients have not been described in detail. This case report describes a patient with erotomania who developed stalking behavior and victimized his attending psychiatrist. The relevance of stalking for clinical practice, the context of stalking behavior, and underlying psychiatric disorders and legal issues are discussed.

Adult↗

Stalking following the breakup of romantic relationships: characteristics of stalking former partners.

This study investigated female experiences of stalking by former partners following the dissolution of heterosexual romantic relationships. It aimed to identify those characteristics of former partners that were associated with stalking as opposed to other post-relationship experiences of minor harassment or no-harassment. Three hundred and five female undergraduates (all had experienced dissolution of a heterosexual romantic relationship) completed a 48-item questionnaire. This assessed characteristics of participants, former partners, and experiences of harassment following the relationship. One hundred and five (34.4%) participants were classified as stalking victims; ninety-eight (32.1%) as suffering harassment, and 102 (33.4%) as experiencing no-harassment. No differences were found between the three groups in demographic characteristics of participants or former partners. Stalking former partners were most likely to have: a history of substance use (alcohol and/or drugs); criminal involvement; violence; mental health problems; difficulties in forming relationships; reacting with inappropriate emotion and jealousy and suspiciousness of the participant's relationships with others. These results add to an emerging profile of former partners who are likely to engage in stalking following the dissolution of romantic relationships. The findings are also consistent with explanations of stalking behavior that stress the etiological importance of attachment difficulties.

Adult↗

Obsessions and compulsions: psychometric properties of the Padua Inventory with an American college population.

The psychometric properties of the Padua inventory, a self-report measure of obsessive-compulsive behaviors, were examined in a sample of 678 American college students. Results showed good internal consistency as well as convergent and divergent validity with the subscales of the Symptom Checklist-90 Revised and the Maudsley Obsessional-Compulsive Inventory. A principal components analysis suggested a four factor solution (i.e. 'impaired control of mental activities', 'checking', 'urges and worries of losing control of motor behaviors', and 'being contaminated'). The factor structure was very similar to that found in the original Italian study of the inventory. Suggestions are made for the use of the Padua Inventory in the study of obsessions and compulsions in nonclinical samples.

Adolescent↗

Hypervigilance and attentional fixedness in chronic musculoskeletal pain: consistency of findings across modified stroop and dot-probe tasks.

UNLABELLED: Results from modified Stroop and dot-probe tasks have provided mixed evidence regarding attentional biases for sensory and affect pain stimuli in chronic pain patients. No studies have compared the same groups of chronic pain and healthy control participants on both tasks. We tested 36 patients with chronic musculoskeletal pain and 29 healthy control subjects on the modified Stroop and dot-probe tasks. Stimuli comprised affect pain, sensory pain, physical catastrophe, and neutral words. There was no evidence to suggest differential processing of threat cues by patients and control subjects on the modified Stroop task. All participants did, however, show differential processing of affect pain words. This was evident on both masked and unmasked presentation formats. There were no significant interactions between clinical status and threat word type observed for any of the indices of selective attention derived from the dot-probe task, but all participants had difficulty disengaging attention from affective pain and health catastrophe words. Findings were not influenced by individual differences in mood, anxiety, or fear of pain. Correlational analyses of the standard (unmasked) Stroop interference index and dot-probe indices of selective attention revealed a consistent lack of significant association, suggesting that the 2 tasks might be measuring different phenomena. Taken together, these findings provide evidence that chronic pain patients and healthy control participants do not differ in the way they attend to threatening linguistic stimuli. PERSPECTIVE: Some patients with chronic pain might have trouble paying attention to anything other than the affective components of pain and associated catastrophic health consequences. Interventions that specifically target this attentional fixedness might facilitate shifting attention to other targets and thereby reduce pain-specific anxiety and fear.

Adolescent↗

A comparison of the Yale-Brown Obsessive Compulsive Scale for "heavy drinking" with a single item craving measure: construct validity and clinical utility.

The measurement of alcohol "craving" began with single-item scales. Multifactorial scales developed with the intention to capture more fully the phenomenon of craving. This study examines the construct validity of a multifactorial scale, the Yale-Brown Obsessive Compulsive Scale for heavy drinking (Y-BOCS-hd). The study compares its clinical utility with a single item visual-analogue craving scale. The study includes 212 alcohol dependent subjects (127 males, 75 females) undertaking an outpatient treatment program between 1999-2001. Subjects completed the Y-BOCS-hd and a single item visual-analogue scale, in addition to alcohol consumption and dependence severity measures. The Y-BOCS-hd had strong construct validity. Both the visual-analogue alcohol craving scale and Y-BOCS-hd were weakly associated with pretreatment dependence severity. There was a significant association between pretreatment alcohol consumption and the visual-analogue craving scale. Neither craving measure was able to predict total program abstinence or days abstinent. The relationship between obsessive-compulsive behavior in alcohol dependence and craving remains unclear.

Adult↗