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[Psychological aspects of facial trauma].

The anatomic lesions resulting from facial trauma have serious psychological implications. The topic can be divided into three parts. First, the psychological trauma begins by a simple conception of the psychic structure. Secondly, an external crust protects an inner structure whose role is to maintain a vital function and a pleasure function. Thirdly, the face materializes these two functions. Facial trauma totally disrupts the external crust with staggering psychic implications, releasing the archaic process of survival. After this initial event, a second step is required where the trauma is interiorized leading to a highly variable clinical course which involves recovery, disturbed memory, and a depressive syndrome. The clinical manifestations and possibilities for preventing the post-commotional syndrome are also discussed together with the psychological disorders implied with facial traumatism: disorders linked to the perception of the face, esthetic damage, neurological and sensorial disorders. The course is basically linked to the personality of the patient.

Attitude to Death↗

Stroke in painters.

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Adaptation, Physiological↗

Developmental dyslexia: specific phonological deficit or general sensorimotor dysfunction?

Dyslexia research now faces an intriguing paradox. It is becoming increasingly clear that a significant proportion of dyslexics present sensory and/or motor deficits; however, as this 'sensorimotor syndrome' is studied in greater detail, it is also becoming increasingly clear that sensory and motor deficits will ultimately play only a limited role in a causal explanation of specific reading disability.

Articulation Disorders↗

Unawareness of deficits after right hemisphere stroke: double-dissociations of anosognosias.

OBJECTIVES: The aim was to study whether anosognosia for hemiparesis, anosognosia for neglect and general unawareness of illness double-dissociate, indicating that anosognosias are specific and independent impairments of awareness. On the other hand, anosognosias may be associated with one another and with general cognitive dysfunction, which decreases awareness of deficits. The persistence and predictive value of anosognosias was examined during a 1-year follow-up. PATIENTS AND METHODS: Fifty-seven consecutive patients with acute right hemisphere infarction underwent neurological and neuroradiological examinations, neuropsychological testing and an interview 10 days, 3 months and 1 year after onset. RESULTS: Anosognosia for neglect and anosognosia for hemiparesis double-dissociated, as did unawareness of illness and anosognosia for neglect. Patients showing unawareness of illness or anosognosia for neglect and anosognosia for hemiparesis had poorer orientation and verbal memory than patients who were aware of these defects. Unawareness of illness and anosognosia for hemiparesis disappeared during 3-month follow-up. CONCLUSION: Double-dissociations demonstrate that anosognosias for different defects are independent and specific impairments of awareness, although general cognitive disorder may also reduce awareness of defects. Unawareness of illness and anosognosia for hemiparesis disappear rapidly and can hardly be direct causes of poor long-term recovery. However, transient anosognosia may be associated with persistent disorders which result in poor outcome.

Aged↗

Turning a deaf ear to fear: impaired recognition of vocal affect in psychopathic individuals.

The processing of emotional expressions is fundamental for normal socialization and interaction. Reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (R. J. R. Blair, 1995). The current study investigates the ability of adult psychopathic individuals to process vocal affect. Psychopathic and nonpsychopathic adults, defined by the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), were presented with neutral words spoken with intonations conveying happiness, disgust, anger, sadness, and fear and were asked to identify the emotion of the speaker on the basis of prosody. The results indicated that psychopathic inmates were particularly impaired in the recognition of fearful vocal affect. These results are interpreted with reference to the low-fear and violence inhibition mechanism models of psychopathy.

Adult↗

Phonologic processing in adults who stutter: electrophysiological and behavioral evidence.

Event-related brain potentials (ERPs), judgment accuracy, and reaction times (RTs) were obtained for 11 adults who stutter and 11 normally fluent speakers as they performed a rhyme judgment task of visually presented word pairs. Half of the word pairs (i.e., prime and target) were phonologically and orthographically congruent across words. That is, the words looked orthographically similar and rhymed (e.g., thrown, own) or did not look similar and did not rhyme (e.g., cake, own). The phonologic and orthographic information across the remaining pairs was incongruent. That is, the words looked similar but did not rhyme (e.g., gown, own) or did not look similar but rhymed (e.g., cone, own). Adults who stutter and those who are normally fluent exhibited similar phonologic processing as indexed by ERPs, response accuracy, and RTs. However, longer RTs for adults who stutter indicated their greater sensitivity to the increased cognitive loads imposed by phonologic/orthographic incongruency. Also, unlike the normally fluent speakers, the adults who stutter exhibited a right hemisphere asymmetry in the rhyme judgment task, as indexed by the peak amplitude of the rhyming effect (difference wave) component. Overall, these findings do not support theories of the etiology of stuttering that posit a core phonologic-processing deficit. Rather we provide evidence that adults who stutter are more vulnerable to increased cognitive loads and display greater right hemisphere involvement in late cognitive processes.

Acoustic Stimulation↗

Discrimination of time-altered sentential approximations and monosyllables by children with reading problems.

This study compared the performance of normal-reading and reading-impaired children using time-compressed three- and five-word sentential approximations to full grammaticality, and the Word Intelligibility by Picture Identification (WIPI) test presented with and without pictures. Results suggested that reading-impaired children could be differentiated from normal readers by scores on these measures and by types of errors made. Theoretical and pragmatic implications are discussed.

Child↗

Information processing by school-age children with specific language impairment: evidence from a modality effect paradigm.

School-age children with specific language impairment (SLI) and age-matched controls were tested for immediate recall of digits presented visually, auditorily, or audiovisually. Recall tasks compared speaking and pointing response modalities. Each participant was tested at a level that was consistent with her or his auditory short-term memory span. Traditional effects of primacy, recency, and modality (an auditory recall advantage) were obtained for both groups. The groups performed similarly when audiovisual stimuli were paired with a spoken response, but children with SLI had smaller recency effects together with an unusually poor recall when visually presented items were paired with a pointing response. Such results cannot be explained on the basis of an auditory or speech deficit per se, and suggest that children with SLI have difficulty either retaining or using phonological codes, or both, during tasks that require multiple mental operations. Capacity limitations, involving the rapid decay of phonological representations and/or performance limitations related to the use of less demanding and less effective coding and retrieval strategies, could have contributed to the working memory deficiencies in the children with SLI.

Child↗

Negotiation skills of children with specific language impairment.

This study examined the ability of 6 children with specific language impairment (SLI), ages 8; 10 to 12;5 (yr; mon) to participate in a negotiation sequence with 2 same-age peers in triadic interactions. Negotiation sequences were analyzed using a system based on Selman's interpersonal negotiation strategies (INS) model (Selman, 1981). The negotiation skills of children with SLI were compared to those of 6 children matched for chronological age (CA) and 6 children of similar language (LS) abilities, participating in the same task. Children with SLI did not produce significantly fewer utterances than the partners with whom they interacted. However, they did produce a significantly smaller percentage of the negotiation strategies produced by their triads. They also used developmentally lower level strategies than either of the partners in their triads. Children interacting within the CA and LS triads did not produce similar differences.

Child↗

Impaired visuo-motor skills in the unaffected lower limb of patients with stroke.

To study the motor skills of the unaffected lower limb of patients with stroke, the visuo-motor skills of the unaffected lower limb in patients with stroke was compared with those in healthy control subjects using a computerized motor skill analyzer that calculated the accuracy in the tracking task in terms of lap time and trajectory error. Trajectory errors in the task by the unaffected lower limb in the patients with stroke were significantly greater than those in the lower limb of healthy control subjects. These results suggest that patients with stroke have impaired visuo-motor skills of the unaffected lower limb.

Adult↗

Motor neglect: implications for movement and rehabilitation following stroke.

PURPOSE: The syndrome of unilateral neglect following stroke is associated with poor outcome and presents significant challenges to those providing therapy for affected individuals. In contrast to a number of reviews which have recently appeared in therapy and rehabilitation journals relating to sensory aspects of neglect, this review focuses on 'motor neglect'. SEARCH STRATEGY: We searched the clinical and scientific literature for papers concerning motor neglect. The search included the databases Web of Science, Pubmed and Cinahl, primarily using the term 'motor neglect'. There was also a large degree of secondary searching involved. DISCUSSION: Motor neglect refers to the under-utilization of a limb opposite a brain lesion that cannot be fully explained by primary sensory and motor deficits. The paper discusses classical descriptions of motor neglect and highlights the difficulties in disentangling motor neglect from hemiparesis. The related problem of motor extinction is introduced as a useful clinical measure of neglect-related movement difficulties and a significant clinical problem in its own right. CONCLUSION: Motor neglect is a relatively under-recognized deficit which may have a significant impact on patient performance and recovery following stroke. We conclude with a discussion of the implications of motor neglect for rehabilitation, including the relative contributions that may be made by Constraint-induced movement therapy and Bilateral movement therapy in managing patients with neglect-related movement problems.

Evidence-Based Medicine↗

Visual impairment and ocular abnormalities in children with fetal alcohol syndrome.

Children with fetal alcohol syndrome (FAS) may have impaired vision and various ocular abnormalities. All parts of the eye may be affected and anomalies such as microphthalmus, microcornea, Peters' anomaly, cataract, persistent hyperplastic primary hyaloid vitreous body, coloboma of the iris and choroid, retinal dysplasia and, most commonly, optic nerve hypoplasia and tortuosity of the retinal vessels, have been reported. The periocular facial features consist of short palpebral fissures (included in the criteria for diagnosis of FAS), telecanthus, epicanthus and blepharoptosis. Visual function may be reduced to a moderate or severe degree. Refractive errors and strabismus are common. Considering the high frequency of ocular pathology in FAS, an ophthalmological examination is helpful in making the diagnosis. The early detection of impaired vision and ocular abnormalities in affected children is important in the management of the disorder. In this article, the ophthalmological signs and symptoms in children with FAS are presented.

Child↗

Language and visuospatial impairment in a case of crossed aphasia.

Crossed aphasia in dextrals (CAD) constitutes an interesting model for understanding the lateralisation and interaction of language with other cognitive functions in the brain. The authors present a study of a right-handed patient with Wernicke's aphasia following a right hemisphere cerebrovascular accident, who also had impairment in visuospatial skills. Although the patient presented a remarkable improvement in language symptoms on longitudinal follow-up, the combination of linguistic, visuospatial, and attentional impairments ultimately resulted in a persisting inability to perform complex tasks. The study of mild residual disturbances can improve our understanding of the interaction of language with other cognitive functions, going some way towards explaining the particular features found in CAD.

Adult↗