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PubMed1997

Pastoral counseling: an alternative path in mental health.

Claims that a strong professional identity is key to offering a healing presence and that pastoral counselors can use their dis-ease with conflicting paradigms and wave-trends in mental health care and the wider culture to maintain a professional identity rooted in the history of pastoral care and their respective theological and psychological world-views. Identifies these wave-trends as the defensive use of language, the medicalization of normal human experience, the lack of interest in developmental perspectives on human life, and the overlooking and denial or internal mental processes of persons. Introduces the concept of pastoral counseling as cultural critique and points out implications of this for the direction of the profession of pastoral counseling.

Clergy↗
PubMed2026

Cognitive impairment as a manifestation of SPG7: case report.

Hereditary spastic paraplegia (HSP) is a group of genetic disorders caused by >80 genes that can be described as either pure or complex forms.We report a case of a patient with a complex form of SPG7 with significant cognitive impairment.A 42-year-old man presented with a 10-year history of dysarthria, 5 years of gait difficulties, and 3 years of cognitive symptoms. Neuropsychological analysis showed deficits involving speed of information processing, mental flexibility, ideational fluency, verbal concept formation, visual working memory, and visual-spatial perception. Next-generation sequencing on whole blood revealed 2 heterozygous pathogenic variants in SPG7 (c. 1049_1077del, p. Pro350Glnfs*36 and c. 1529C>T, p. Ala510Val).There are emerging reports of complex forms of SPG7 presenting with impairments in memory, executive dysfunction, language, visuospatial processing, social functioning, and emotional communication. In this report, we describe a complex SPG7 patient who underwent formal neuropsychological testing to assess cognitive status in depth. This revealed deficits in speed of processing, visuospatial working memory and perception, impaired non-verbal intellect, and overall lack of insight, which have not yet been described in the literature.

Cognitive impairment↗
PubMed2003

The origin of brain asymmetry and its psychotic reversal.

Ontogenetic brain-asymmetry and its reversal in schizophrenia constitute special cases of a more fundamental principle of sensory-motor integration. Transmitted through an immature optical system, asymmetric inputs from the left visual field induce the infant's right hemispheric preference for lower spatial frequencies during early mother-child interaction. The emerging classical features of hemispheric specialisation later in life can be accounted for by a transformation law of the neuronal reference frames based on relativistic non-linear information processing. Accordingly, the asymmetric distributions of the cannabinoid receptor CB1 in the right basal ganglia and the left area of Wernicke reflect the preferences for lateralised posture, positioning, and speech. Epigenetic development of brain asymmetry thus unifies the different aspects related to cradling and breast-feeding, speech- and visuospatial processing, the dimensional conversion of spatiotemporal information and, in the case of a dysbalanced cannabinoid system, its psychotic reversal. The predicted right hemispheric shift and the inverse relationship between Kolmogorov entropy and its dimensional embedding (Shannon entropy) has ultimately been confirmed by non-linear EEG analysis of a fluoro-methyl-anadamide induced model psychosis splitting conscious from unconscious mental processes.

Brain↗
PubMed1987

Rethinking the unconscious: the unacknowledged contribution of Edward Sapir to Claude Lévi-Strauss and Jacques Lacan.

Sapir defined the human unconscious as a mechanism (based on phonemes learned during language acquisition) which imposes linguistic forms upon out-of-awareness 'psychic content' or 'elements of experience', rather than as a repository of repressed impulses or ideas striving for expression. In contemporary terms this activity may be regarded as unconscious information processing prequisite to experiential residues becoming available to conscious attention. It also imposes (as in 'projecting') the observer's cultural forms, modified by developmental experience, upon communications from others. This view antedates Lévi-Strauss' unconscious which 'transforms' elements of the past 'into language' and Lacan's unconscious structured 'like a language'. The clinical psychoanalytic study of out-of-awareness mental processes, understood as a dialectic shaped by the discrepancy in power between analyst and patient, illuminates the unstable relationship between the words or signifiers selected by the patient from the infinite lexicon of available, usually socially shared, verbal or non-verbal language (his plane of expression) and his varied preconscious collections of signifieds, including cultural as well as personal developmental knowledge (his plane of content).

Freudian Theory↗
PubMed1989

Aging and the word frequency effect: a lexical decision investigation.

It is known that speed and accuracy in recognizing words are constrained by their frequency of occurrence ("frequency effect"). This study bears on the diachrony of the word frequency effect. Our postulates in this respect were (1) that a significant frequency effect should be present throughout adulthood, irrespective of age, and (2) that the magnitude of this effect should be greater among the elderly. Twenty young and 20 older healthy adults were submitted to a lexical decision experiment. Results confirmed our first postulate but invalidated the second one, that is, significant frequency effects were found in both groups but these effects were documented to be of identical magnitude. An attempt is made at explaining the latter result from a theoretical standpoint. The former is interpreted as further evidence that senescence (normal aging) does not interfere with passive, automatic and unconscious mental processes. Moreover, it is suggested that--if observed among otherwise apparently healthy elderly adults--modifications of the frequency effect might be taken as a cognitive marker of disease.

Adult↗
PubMed2005

[Working memory in basic learning processes].

INTRODUCTION AND DEVELOPMENT: Working or operative memory is considered to be a distinctive element of executive functioning. Nowadays, thanks to neuroimaging studies, it is known that the dorsolateral prefrontal cortex plays a crucial role in working memory. It has been observed that during the intervals when information is being retained, intense and persistent activity is going on in the region, as shown by the delayed response times. Working memory is fundamental for the analysis and synthesis of information, the retention of data needed to perform a particular mental process, carrying out priming (impression in memory of something that has been experienced, such as words, objects or events, for example), carrying out pre-functional tutoring activities and post-functional monitoring. CONCLUSIONS: Disorders affecting the fundamental mechanisms of working memory will give rise to a dysfunction that will exert an influence on innumerable formal academic learning processes such as difficulty in focusing attention, difficulty in inhibiting irrelevant stimuli, difficulty in recognising priority patterns, inability to recognise hierarchies and the meaning of stimuli (analysis and synthesis), problems in establishing an intention, and difficulty in recognising and selecting the goals that are best suited to solving a problem. It will also involve the impossibility to establish a plan to achieve goals, inability to analyse the activities required to accomplish an objective and difficulties in carrying out a plan, since it becomes impossible to monitor or modify the task to fit the original plans.

Learning↗
PubMed1995

Memory and consciousness: an appreciation of Claparède and recognition et moiïtè.

Claparède's report of a case of amnesic syndrome is an early example of the cognitive neuropsychology paradigm, by which studies of brain-damaged patients are used to shed light on the nature of normal mental processes. The case illustrates the selective impairment of episodic memory, with procedural and semantic memory remaining intact. Moreover, the several demonstrations of preserved learning during amnesia comprise an early illustration of the dissociation between explicit and implicit memory. However, its greatest contemporary relevance is for theories of conscious recollection. Claparède underscored the role of the self, viewed as a knowledge structure, in conscious mental life, and he drew attention to three different modes of recognition: remembering, inferring, and knowing.

Cognition↗
PubMed1996

The validation of psychoanalytical hypotheses in clinical practice.

Grünbaum's critique of the scientific rigour of psychoanalysis has led psychoanalysts to seek validation of its theory in clinical practice. The author argues that it is overlooked, however, that Freud described a method by means of which psychoanalysis is already perfectly able to justify its theoretical assumptions, in accordance with the rules of empirical induction recognised by Grünbaum. This method not only establishes clinical data, but also shows the Tally Argument to be valid, enables a specific cause of neurosis to be retrodictively identified and makes the process of cure peculiar to psychoanalysis intelligible in a new way. The main focus of the article is on Freud's description of a special feature of neurotic illusion or self-deception. Freud equates neurosis with what seventeenth- and eighteenth-century philosophical tradition termed Rationalism, in contrast to Empiricism. If the references scattered throughout Freud's works to rationalistic phenomena in neurotic mental processes are collated, the result will be a catalogue of indicators, the disappearance of which in the course of treatment will confirm the correctness of psychoanalytical statements about the causes of neurosis.

Defense Mechanisms↗
PubMed2003

Haptic synthesis of shapes and sequences.

Haptic perception of shape is based on kinesthetic and tactile information synthesized across space and time. We studied this process by having subjects move along the edges of multisided shapes and then remember and reproduce the shapes. With eyes closed, subjects moved a robot manipulandum whose force field was programmed to simulate a quadrilateral boundary in a horizontal plane. When subjects then reproduced the quadrilateral using the same manipulandum, with eyes still closed but now with the force field set to zero, they made consistent errors, overestimating the lengths of short segments and underestimating long ones, as well as overestimating acute angles and underestimating obtuse ones. Consequently their reproductions were more regular than the shapes they had experienced. When subjects felt the same quadrilaterals with the same manipulandum but drew them on a vertical screen with visual feedback, they made similar errors, indicating that their distortions reflected mainly perceptual rather than motor processes. In a third experiment, subjects explored the 3 sides of an open shape in a fixed order. The results revealed a temporal pattern of interactions, where the lengths and angles of previously explored segments influenced the drawing of later segments. In all tasks, our subjects were as accurate as subjects in earlier studies who haptically explored only single lines or angles, suggesting that the mental processes that synthesize haptic data from multiple segments into complete shapes do not introduce any net error.

Adolescent↗
PubMed1987

Mental impairment in unilateral frontal tumours: role of the laterality of the lesion.

Seventy-two patients with left frontal lobe tumours and 68 patients with right frontal lobe tumours were studied clinically and experimentally. Left frontal lobe tumours were consistent with poorer motor and mimical activity, speech disturbances, manifested as efferent motor or dynamic aphasia, slowing down of the tempo of mental processes, deterioration of verbal memory, reduced generalization ability, difficulties in attention shifting and stereotyped thinking. In mild cases, the above impairments were associated with depressed feelings, in advanced cases with apathico-abulic syndrome. Right frontal lobe tumours were found to raise spirits and led to euphoria, underestimation of one's disorder and full anosognosia, loss of critical faculty, attention instability and distractibility. Development of mental disorders in left-sided frontal tumours mainly depends on tumour localization, while in right-sided ones tumour size and malignancy are the determining factors.

Adult↗
PubMedDate not supplied

[Multiband spectral analysis and standardized markers of the slope of pediatric electroencephalograms].

INTRODUCTION: The infantile electroencephalogram has been studied in connection with many cognitive disabilities. Although normal resting infantile bioelectric recordings are known, the cortical distribution of electroencephalographic frequencies during other sensory and/or cognitive mental processes is less well known. OBJECTIVE: Our interest is based on the description of EEGs of a homogeneous sample of healthy children and their relation to intellectual activities. MATERIAL AND METHODS: The sample studied was made up of 13 healthy children with an average age of 9.3 +/- 1.3 years, on whom two types of tests of attention were done. One of the tasks was a simple auditory memory test and consisted of the spoken repetition of a series of numbers previously heard, which was of variable length. The second test consisted of the identification and crossing out of one face of a series of three faces, which included one which was different from the others. The methodology chosen was electroencephalographic measurement in the frequency and temporal domains. RESULTS AND CONCLUSIONS: There was a relative increase in beta frequencies in all cortical sites which was significant in T3 and T4 with the auditory test and in all electrodes with the visual test. During auditory testing reduction in the alpha frequency was observed in frontotemporal regions. The greatest cortical variations of beta frequency occurred, in the facial test, in the electrodes O2, T6, O1, T5 and T3. The values of Hjorth complexity obtained varied within the interval 1 to 3, which was a considerably lower interval than that found in adult populations.

Attention↗
PubMed1998

Body image and psychopathology in adolescence: a controlled clinical study.

The aim of this study was to investigate mentally disturbed adolescents' problems of acknowledging and accepting the physical changes and sexual maturation of their bodies, in comparison with healthy adolescents. The study sample consisted of 60 adolescents (30 boys and 30 girls), 15-18 years of age, who had been referred for psychiatric examination, and 60 healthy controls, matched on the basis of age, sex, place of residence and level of education. The study methods were the self-rated questionnaire and psychiatric in-depth interview modified on the basis of the diagnostic profile of adolescents. Mentally disturbed adolescents had more negative attitudes towards developmental body changes than healthy adolescents. They were unable to describe the physical changes they had undergone. Healthy adolescents were more aware of developing sexual characteristics. On discriminant analysis, independent background variables explaining problems relating to sexual maturation in mentally disturbed adolescents were found to be a lack of or low number of peer relationships, and long-term stress. In the healthy adolescents, independent variables associated with problems in sexual maturation were found to be a lack of or low number of peer relationships and a single-parent home. We conclude that adolescents with psychiatric problems seem to have a poorer capacity to process mentally the ongoing bodily and sexual maturation of their bodies than matched healthy controls.

Adaptation, Psychological↗
PubMed2006

The attention-intention-effort pathway in the development of psychophysiologic insomnia: a theoretical review.

Psychophysiologic insomnia (PI) is the most common form of persistent primary insomnia. Its 'behavioral phenotype', comprising elements such as conditioned arousal, sleep-incompatible behavior and sleep preoccupation, has not changed markedly across several generations of diagnostic nosology. Moreover, a substantial outcome literature demonstrates that PI can be treated effectively using a range of psychological interventions. It seems evident that behavioral and cognitive factors play a part. What is less clear is exactly how PI develops and what are its crucial maintaining factors. This paper proposes an explanatory model, that we call the attention-intention-effort pathway. The argument is that sleep normalcy is a relatively automatic process. Consequently, it is vulnerable, and may be inhibited, by focused attention and by direct attempts to control its expression. Drawing upon parallels in the literature on adult psychopathology, and upon recent clinical and experimental studies on insomnia, the evidence for this pathway is considered and a research agenda is outlined. In particular, computerized tests of cognitive bias are seen as offering an objective means of appraising mental processes in insomnia. These may be applied concurrently with somatic measurements in future studies to better understand this common psycho-physiologic condition.

Attention↗
PubMed2004

[Comorbidity of mental disorders in the German G-DRG system -- effect on length of stay and revenue at a university hospital].

OBJECTIVES: The effect of comorbid mental disorders on the length of stay and revenue in a DRG system was investigated. METHODS: For 33,189 cases of an university hospital (year 2002) the revenue based on a fictitious base rate was calculated, at first with and then without inclusion of diagnosed comorbid mental disorders. Furthermore, the effect of the latter on the length of stay was examined. RESULTS: Renunciation of diagnoses of mental disorders lead to an different DRG grouping in 7.9 % of cases and to a reduction in revenues of about 170.000. Minimal influence of comorbid mental disorders on the length of stay (R2 = 0.02) could be detected for single diagnostic groups. CONCLUSIONS: The lacking influence of comorbid mental disorders on the length of stay in a university hospital is mainly determined by the limited period of inpatient treatment and by the low frequency of diagnosed mental disorders. Therefore, a psychosocial consultation-liaison service is of major importance to guarantee the diagnosis and treatment of a comorbid mental (process quality) disorder and to guarantee adequate revenues in the G-DRG system (quality of structure).

Adult↗
PubMed1979

An holistic developmental view of neural and psychological processes: a neurobiologic-psychoanalytic integration.

The authors attempt to integrate several psychoanalytical and more recent neurobiological concepts regarding the development of the organism and emergence of psychopathology. They highlight the rough temporal correspondence of neurodevelopmental myelination cycles with stages of psychosocial development. They discuss concepts of critical periods and unique times of vulnerability to psychosocial insult and recurrence of critical stresses, gleaned from a multidisciplinary point of view, in relation to the occurrence of psychic aberrations. They suggest that it may be fruitful to explore further psychological constructs such as fixation and regression, as well as unconscious mental processes, in relation to their biochemical, physiological, and anatomical representations in the brain.

Animals↗
PubMed2001

The intrusiveness of sound: Laboratory findings and their implications for noise abatement.

Environmental policy with regard to noise abatement has traditionally only considered whether the noise levels in a given setting are high enough to be deemed a source of annoyance, disturbance, or threat to well being. However, laboratory studies using both simple and more complex work-related tasks have shown that task-irrelevant sound, regardless of its intensity, intrudes upon cognitive processing and disrupts performance substantially; furthermore, its damaging effect does not diminish with repeated exposure to the sound over time. For tasks that require short-term memory processing (particularly the short-term maintenance of order information) sound assumes disruptive power if it is acoustically varying over its time course. However, other properties of sound (e.g., the semanticity of speech) can incur an additional cost if the primary task necessitates or tends to evoke the extraction of meaning. It will be argued that interference in each case is explained by reference to a conflict between two concurrent mental processes; that being demanded by the task and that being involuntarily applied to properties of the sound. Such harmful effects, as well as having direct consequences for the general well-being of those working in noisy environments, may have far reaching consequences for health insofar as extraneous sound is a feature of many safety-critical work settings. Implications for noise abatement policy are highlighted.

Journal Article↗
PubMed2006

Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients.

BACKGROUND: Extended periods of hypoperfusion in an advanced heart failure (HF) places patients at high risk for neurobehavioral compromise, which has not been studied systematically. It is also not clear how intravenous inotropic therapy and mechanical cardiac assist devices (MCAD) affect cognitive function. METHODS: This prospective cross-sectional cognitive preliminary study evaluated 252 potential heart transplant candidates assessing functions in memory, motor, and processing speed. Patients were divided into three HF groups based on severity of disease: group 1 outpatients (n = 113), group 2 in-patients requiring inotropic infusion (n = 83), and group 3 inpatients likely requiring MCAD support (n = 56). Aggregate z-scores for memory, motor, and processing speed and independent samples t tests assessed intergroup differences on 13 cognitive measures. RESULTS: A broad pattern of cognitive impairment was observed within the advanced HF group; fewer deficits were found in group 1 outpatients and more severe deficits in group 3 MCAD subjects. A difference in motor functions was observed as the earliest abnormality, with group 3 showing significant changes compared with group 1. The most dramatic changes were seen in domain mental processing speed along with specific verbal and visual memory functions, which were slower in group 3 compared with groups 1 and 2. CONCLUSIONS: Cognitive deficits are common in advanced HF and worsen with increasing severity of HF. Appropriately designed and randomized studies will be needed to demonstrate if earlier MCAD implantation is warranted to arrest cognitive dysfunction and better postimplantation adaptation.

Adult↗
PubMed1982

Analysis of disagreement in the evaluation of clinical products.

This paper reports an analysis of factors that reduce agreement in clinical evaluation. Four instructors representing different restorative departments met regularly over a four-month period to study the evaluation process. Each participant selected a task from his discipline, identified critical errors made in performing the task, produced these errors in models and extracted teeth, and developed criteria and checklists to aid in categorizing and counting the errors. In weekly sessions the models were evaluated, and judgments were compared. Factors that reduced agreement were identified, discussed, and listed. In some sessions ongoing evaluation was reported orally, tape-recorded, and analyzed to elucidate the underlying mental processes. Analysis indicated that agreement was reduced by 16 factors, including unclear rules, the faculty member's memory, unstandardized aids to judgment, inconsistent observational methods, differences in ability, and differing tendencies to leniency.

Clinical Competence↗