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PubMed1987

Psychoanalytic observations on the effect of lithium on manic attacks.

This paper describes a predictable relation between our manic-depressive patients' blood lithium levels and particular changes in their conscious and unconscious mental processes (i.e., their thoughts, wishes, fantasies, inclinations, and feelings). These changes were, in turn, predictively related to specific changes in these patients' overt manic symptomatology. Because each of our patients' manic episodes was heralded by a marked increase in unconscious or conscious phallic sexual thoughts, feelings, and behaviors, and because this increase preceded any observed deterioration in ego or superego functioning, we hypothesize that a primary increase in our patients' phallic instinctual drives secondarily overwhelmed the capacity of their egos to defend against these drives, and that this, in turn, resulted in the development of our patients' overt manic symptoms. Psychoanalysis (or psychoanalytically oriented psychotherapy) made our patients consciously aware both of their previously unconscious phallic sexual thoughts and impulses, and of their defenses against them. This new awareness enabled our patients to recognize when their, now conscious, phallic sexual impulses and thoughts became inappropriately intensified; and this, in turn, permitted them to avoid overt manic episodes by counteracting these inappropriate inclinations with increased doses of lithium.

Adult↗
PubMedDate not supplied

Improving the reading comprehension of children with dysphonetic and dyseidetic dyslexia using story grammar.

Five 8- to 10-year-old children with dysphonetic and dyseidetic dyslexia were given instruction in reading comprehension using a story grammar strategy in which story instruction was differentially designed to match the simultaneous or sequential mental processing strengths of each dyslexia subtype. A multiple baseline, single subject experimental design and statistical analyses indicated that the experimental treatments yielded statistically and clinically significant improvements in the proportion of qualitatively important story elements recalled by the subjects, when compared to baseline traditional remedial instruction. The results suggested that students with dyslexia can increase their reading comprehension with training in metacognitive strategies. The question of whether the results were attributable to the subtype-matched methods per se or to strategy training in general, as well as a number of methodological issues, is being explored in subsequent research.

Child↗
PubMed1995

Representation of mental imagery functions.

A questionnaire was administered to 250 undergraduates to study their conceptions about the efficacy of mental images in thinking. Analysis showed that subjects rated differently the usefulness of visual imagery according to the kind of content rather than the mental process involved.

Adult↗
PubMed2004

Effects of the activation of affective information on stereotyping: when sadness increases stereotype use.

Two studies explored the impact of mere activation of affective information on the use of stereotypes in social judgment. These studies provided consistent results showing that the activation of information related to sadness increases reliance on stereotypes, whereas the activation of information related to happiness decreases it. These results were obtained in the absence of affective state changes among the participants and with the use of two different priming procedures (Study 1: scrambled sentences, Study 2: subliminal priming) and two different judgment tasks (Study 1: impression formation, Study 2: guilt judgment). Complementing the informational view of affective states, it is suggested that affective information of which people are not conscious activates behavioral tendencies of approach or of avoidance associated with the related emotion.

Adult↗
PubMed2001

Concurrent validity of the Peabody Picture Vocabulary Test-Third Edition as an intelligence and achievement screener for low SES African American children.

Authors tested the validity of the Peabody Picture Vocabulary Test-Third Edition (PPVT-III) as a screening measure for intelligence and achievement. The PPVT-III and Kaufman Assessment Battery for Children (KABC) were administered to 416 African American children of low socioeconomic status in a counterbalanced design. Results indicated that the PPVT-III correlated .58 with the KABC Mental Processing Composite (MPC) score; however, participants scored significantly lower (M = 8.3 points) on the PPVT-III than on the MPC. Although receiver operating characteristic (ROC) analyses supported the use of the PPVT-III as a valid intellectual and achievement screener, the selection of a single cutoff score for the PPVT-III was problematic. The purpose of the screening program should guide selection of a cutoff score for the PPVT-III.

Achievement↗
PubMed2006

Neuroimaging, cognitive, and neurobehavioral outcomes following carbon monoxide poisoning.

Carbon monoxide is a colorless, odorless gas produced as a byproduct of combustion. Carbon monoxide is the leading cause of poisoning injury and death worldwide. Morbidity following CO poisoning includes neurologic sequelae, neuropathologic abnormalities on brain imaging, neurobehavioral changes, and cognitive impairments. It is estimated that as high as 50% of individuals with carbon monoxide poisoning will develop neurologic, neurobehavioral, or cognitive sequelae. Carbon monoxide related cognitive impairments included impaired memory, attention, executive function, motor, visual spatial, and slow mental processing speed. Given the high rate of brain related morbidity and the fact that the majority of carbon monoxide is avoidable, awareness and prevention of carbon monoxide poisoning is warranted.

Brain Injuries↗
PubMed1978

A common language for the psychotherapies?

The account of mental processes emerging from the work of cognitive psychologists is briefly reviewed, and aspects of the theoretical basis of the work of psychoanalytic and behaviourist psychotherapists are considered in the light of this. It is argued that in both traditions increasing attention is being paid to cognitive processes. A restatement of psychoanalytic theory in cognitive terms could free it from its present confusion of metaphors, and an extension of behaviourist theory in this direction could free it from reductionism. The advantages of the adoption of a common language, based on the models of cognitive psychology, to theory, practice and research are briefly considered.

Behavior Therapy↗
PubMed1999

Insulin-like growth factor-I and cognitive function in healthy older men.

The GH/insulin-like growth factor-I (GH/IGF-I) axis is known to be involved in aging of physiological functions. Recent studies indicate that the GH/IGF-I axis may be associated with cognitive functioning. The aim of the present study was to determine whether the age-related decline in circulating levels of IGF-I, as an index of anabolic status, is associated with cognitive functions that are known to decline with aging, but not with cognitive functions not sensitive to aging. Twenty five healthy older men with well-preserved functional ability participated in the study. We also administered neuropsychological tests of general knowledge, vocabulary, basic visual perception, reading ability, visuoconstructive ability, perceptual-motor speed, mental tracking, and verbal long-term memory. Performance on the last four tests decline with aging, whereas the first four of these tests have been shown not to be sensitive to cognitive aging. Mean age of the subjects was 69.1 +/- 3.4 (SD) yr (range 65-76 yr), their mean body mass index was 27.0 +/- 2.4 kg/m2, and their mean IGF-I level was 122 ng/mL (range: 50-220). We found IGF-I levels to be significantly associated with the performances (controlled for education) on the Digit Symbol Substitution test (r = 0.52, P = 0.009) and the Concept Shifting Task (r = -0.55, P = 0.005), which measure perceptual-motor and mental processing speed. Subjects with higher IGF-I levels performed better on these tests, performance on which is known to decline with aging. In conclusion, the results of this study support the hypothesis that circulating IGF-I may play a role in the age-related reduction of certain cognitive functions, specifically speed of information processing.

Aged↗
PubMed1989

Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis.

Previous research has suggested that cerebral lesions observed on magnetic resonance imaging (MRI) of MS patients are clinically "silent." We examined the validity of this assertion by correlating neuropsychological test performance with MRI findings in 53 MS patients. We used a semiautomated quantitation system to measure three MRI variables: total lesion area (TLA), ventricular-brain ratio (VBR), and size of the corpus callosum (SCC). Stepwise multiple regression analyses indicated that TLA was a robust predictor of cognitive dysfunction, particularly for measures of recent memory, abstract/conceptual reasoning, language, and visuospatial problem solving. SCC predicted test performance on measures on mental processing speed and rapid problem solving, while VBR did not independently predict cognitive test findings. These findings suggest that cerebral lesions in MS produce cognitive dysfunction and that MRI may be a useful predictor of cognitive dysfunction.

Brain↗
PubMed1993

Neuropsychologic correlates of MRI white matter hyperintensities: a study of 150 normal volunteers.

To determine the effects of MRI white matter hyperintensities (WMH) on cognitive functioning, we used neuropsychologic tests and MRI to study 150 elderly volunteers free of neuropsychiatric or general disease. There were 76 (50.3%) individuals without and 74 (49.7%) with WMH. The latter subset was older (61.3 +/- 6.6 years versus 58.5 +/- 5.8 years, p = 0.005), had a higher mean arterial blood pressure (103.7 +/- 11.4 mm Hg versus 99.9 +/- 10.3 mm Hg, p = 0.03), and a larger ventricular-to-intracranial-cavity ratio (6.3 +/- 5.6% versus 4.7 +/- 1.6%, p = 0.02). Individuals with WMH performed worse than their counterparts without such abnormalities on all tests administered. After adjusting for the group differences in age, arterial blood pressure, and ventricular size, we noted statistically significant results on form B of the Trail Making Test (121.8 +/- 37.8 msec versus 100.3 +/- 47.9 msec, p = 0.04), a complex reaction time task (680.8 +/- 104.9 msec versus 607.1 +/- 93.9 msec, p = 0.001), and the assembly procedure of the Purdue Peg-board Test (27.5 +/- 5.8 versus 30.6 +/- 5.9, p = 0.02). Partial correlations did not reveal any relationship between test scores and the semiautomatically assessed total area of WMH. Our data suggest that the presence of WMH exerts a subtle effect on neuropsychologic performance of normal elderly individuals, which becomes particularly evident on tasks measuring the speed of more complex mental processing.

Adult↗
PubMed1998

Levodopa improves motor function without impairing cognition in mild non-demented Parkinson's disease patients. Parkinson Study Group.

OBJECTIVE: The objective of the study was to determine the effects of short-term levodopa administration on motor, cognitive, and psychiatric aspects of Parkinson's disease (PD). BACKGROUND: The effects of levodopa on mental processes in PD are controversial. Opinions range from the claim that levodopa improves cognition to the opposite view that levodopa causes or exacerbates dementia, delusions, and hallucinations. Of the 800 idiopathic PD patients enrolled in the original DATATOP study, 387 reached the end point of functional disabilities sufficiently severe to require levodopa treatment. There were 263 men and 124 women who were comparable with regard to age, symptom duration of PD, and measures of PD severity. We compared test scores on motor performance, cognitive function, and psychiatric status before levodopa and again within 6 months after initiation of levodopa therapy. RESULTS: Levodopa administration improved all motor functions significantly. The improvement was significantly greater in women than in men. Levodopa administration did not worsen scores on any cognitive tests, and there were quantitatively small but significant improvements in tests of frontal lobe function. Levodopa exerted only minor effects on psychiatric measures. There were small but significant decreases in scores for depression, and increases in vivid dreams and hallucinations. CONCLUSIONS: Levodopa administration for up to 6 months in dosages sufficient to improve motor function has only small effects on cognitive function and psychiatric status in mild to moderate PD patients. We conclude that motor symptoms in early PD, which result from dopamine depletion, are dissociable from cognitive functions and psychiatric status, which may be more dependent on nondopaminergic mechanisms.

Aged↗
PubMed2005

Use of methylphenidate in traumatic brain injury.

OBJECTIVE: To review literature regarding the effectiveness of methylphenidate in the management of the cognitive and behavioral changes observed following traumatic brain injury (TBI). DATA SOURCES: A literature search was conducted using the following databases: MEDLINE (1966-June 2004); Cochrane Central Register of Controlled Trials, fourth quarter 2004 (1988-June 2004); and International Pharmaceutical Abstracts (1970-June 2004). Methylphenidate and brain injury were the key search terms used. Limits were set to include clinical trial publications, human subjects, and English language. DATA SYNTHESIS: Ten clinical trials evaluating the efficacy and safety of methylphenidate in pediatric and adult patients with TBI are reviewed. Improvements in different aspects of cognition and behavior were evaluated before, during, and after treatment with methylphenidate. The results demonstrated that methylphenidate is likely to improve memory, attention, concentration, and mental processing, but its effects on behavior have not been determined. CONCLUSIONS: Larger, double-blind, placebo-controlled studies are needed to determine optimal doses, during which phase of recovery to begin treatment, length of treatment, and long-term effects for patients with mild, moderate, and severe TBI.

Brain Injuries↗
PubMed1999

Recognition hypermnesia with repeated trials: initial evidence for the alternative retrieval pathways hypothesis.

The alternative retrieval pathways (ARP) hypothesis of hypermnesia is here proposed. This hypothesis predicts hypermnesia (net improvements in recall or recognition after initial learning) whenever alternative retrieval pathways are provided leading to the original episodic trace. Initial evidence for this hypothesis was obtained in two experiments testing a non-obvious prediction of its format transformation assumption, namely that hypermnesia would be obtained in recognition and would not occur in recall if the former, but not the latter, condition requires obligatory format transformations between item encoding and retrieval. In the first experiment the same participants, exposed to identical items and having analogous encoding and retrieval conditions, showed recognition and did not show recall hypermnesia. With a between-participant design, the second experiment replicated the recognition hypermnesia findings, using a different recognition procedure and three instead of two test trials, whereas recall hypermnesia remained absent. Results are discussed comparing the heuristic value of ARP hypothesis to that of other current theories. It is concluded that recognition hypermnesia using individual words and pictures is a reliable phenomenon, provided ceiling effects can be prevented, and access to the original episodic information takes place using alternative retrieval pathways.

Adult↗
PubMed2004

A psychoanalytical phenomenology of perversion.

After stating that the current tasks of psychoanalytic research should fundamentally include the exploration of the analyst's mental processes in sessions with the patient, the author describes the analytical relation as one having an intersubjective nature. Seen from the outside, the analytical relation evidences two poles: a symmetric structural pole where both analyst and patient share a single world and a single approach to reality, and a functional asymmetric pole that defines the assignment of the respective roles. In the analysis of a perverse patient, the symmetry-asymmetry polarities acquire some very particular characteristics. Seen from the perspective of the analyst's subjectivity, perversion appears in the analyst's mind as a surreptitious and unexpected transgression of the basic agreement that facilitates and structures intersubjective encounters. It may go as far as altering the Aristotelian rules of logic. When coming into contact with the psychic reality of a perverse patient, what happens in the analyst's mind is that a world takes shape. This world is misleadingly coloured by an erotisation that sooner or later will acquire some characteristics of violence. The perverse nucleus, as a false reality, remains dangling in mid-air as an experience that is inaccessible to the analyst's empathy. The only way the analyst can reach it is from the 'periphery' of the patient's psychic reality, by trying in an indirect way to lead him back to his intersubjective roots. At this point, the author's intention is to explain this intersubjective phenomenon in terms of metapsychological and empirical research-based theories. Finally, some ideas on the psychogenesis of perversion are set forth.

Adult↗
PubMed2005

Early trauma and narcissism-autism bipolarity.

The analyst makes a series of considerations taken--a posteriori--from the analysis of a small number of patients. These patients have saved themselves from an early narcissistic catastrophe by developing precocious mental processes, while affective relationships rudimentarily repeat the impact with the original trauma. Primitive defences, essentially denial and vertical splitting, dissociate the tear in the psyche and structure a 'narcissism-autism bipolarity', revealed in aspects of the character which oblige the patient to automatically repeat a single matrix of experience. In therapy, it is necessary to construct a 'first time of the trauma', by finding and linking threads of the primary relationship and strengthening them in the analytic relationship. This reconstruction of the background, a screen to project what had originally been rejected, is the prerequisite for coming out, in deferred action, from the hold of the pathological identifications. The author dedicates particular attention to the undifferentiated background, the nature-environment torn by the trauma, and to the need to reconstruct this fabric of experience in the analytical relationship, as a fundamental element to the recomposition of the dissociated nuclei. In the clinical case, the analyst describes in particular how the analyst's words encounter an unbridgeable gap, a failure in the capacity for representation when opening the autistic nucleus. Through a regression lasting for about a year, a patient was able to live the experience of 'primitive agonies' and that of an unbearable helplessness and, at the same time, was able to feel how the analyst supported her sense of existence. Subsequently, the patient was able to give shape, through visual images, to deep states of being and start the process of metabolising and symbolising the trauma.

Adult↗
PubMed1987

Dreams of the rarebit fiend: neuromedical synthesis of unconscious meaning.

A promising new "ecumenical" movement in psychiatry attempts to synthesize the two great intellectual traditions, psychoanalysis and neurobiology, so that we may avoid splitting the care of the patient into the partial domains of biotherapy that lacks the understanding of mental interrelations and purely psychological psychotherapy that lacks an appreciation of the embeddedness of mental processes in brain function. Recent synthetic work is assessed, taking as a point of departure an historic symposium in Pittsburgh, October 26-27, 1984, entitled "Neurobiology and the Unconscious: Psychoanalysis Looks Toward the Future." The means of representation of meaning (whose description was begun by Freud) in such unconscious material as dreams and folklore show the imprint of the brain function in which they are imbedded. Our afferent and efferent processes, including language, are patterned by their neuromedical basis. Linkages will be sought of representational images to visual, vestibular, and neuromotor traces: evidence that the human "thinking machine" is a very human body rather than some disembodied psychological self or computer simulation by artificial intelligence programming. Illustrative material is in part drawn from the popular dream episodes cartooned by Winsor McCay, which were considered graphic masterpieces, and incorporated representations of many normal unconscious brain mechanisms, including unusual perspectives, vestibular sensations, neuromotor inhibitions, transformations; visual and linguistic distortions, bizarre bodily intrusions, and sexual symbols. J. Allen Hobson and R.W. McCarley's 1977 arguments for the determining the significance of the pontine dream generator may have been anticipated by McCay's 1905 Dreams of the Rarebit Fiend in which, at the end of each very Freudian nightmare, the dreamer wakes and swears off eating welsh rarebits as if they caused all his unconscious images. To avoid a biological reductiveness, Freud, whom Sulloway (1983) has described as a biologist of the mind, resorted to presenting psychoanalysis as a pure psychology, not because he ever doubted the neurological imbeddedness of mind, but only because he felt medical psychoanalysts were too easily seduced and distracted by neurological mechanisms of his day to appreciate properly the importance of psychodynamics. Increasing recognition of the imbeddedness of psychoanalysis in brain function is now timely and likely, providing fresh directions for both medical psychoanalysis and the neurosciences.(ABSTRACT TRUNCATED AT 400 WORDS)

Brain↗