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At least 1,063 records · Page 59Linked to original sources
PubMed2005

Frontotemporal and dopaminergic control of idea generation and creative drive.

This article presents a three-factor anatomical model of human idea generation and creative drive, focusing on interactions between the temporal lobes, frontal lobes, and limbic system. Evidence is drawn from functional imaging, drug studies, and lesion analysis. Temporal lobe changes, as in hypergraphia, often increase idea generation, sometimes at the expense of quality. Frontal lobe deficits may decrease idea generation, in part because of rigid judgments about an idea's worth. These phenomena are clearest in verbal creativity, and roughly parallel the pressured communication of temporal lobe epilepsy, mania, and Wernicke's aphasia-compared to the sparse speech and cognitive inflexibility of depression, Broca's aphasia, and other frontal lobe lesions. The phenomena also shape non-linguistic creativity, as in that of frontotemporal dementia. The appropriate balance between frontal and temporal activity is mediated by mutually inhibitory corticocortical interactions. Mesolimbic dopamine influences novelty seeking and creative drive. Dopamine agonists and antagonists have opposite effects on goal-directed behavior and hallucinations. Creative drive is not identical to skill-the latter depends more on neocortical association areas. However, drive correlates better with successful creative output than skill does. Traditional neuroscientific models of creativity, such as the left brain - right brain hemispheric model, emphasize skills primarily, and stress art and musical skill at the expense of language and mathematics. The three-factor model proposed here predicts findings in a broad range of normal and pathological states and can be tested in many experimental paradigms.

Creativity↗
PubMed2006

Surviving in absence--on the preservative and death drives and their clinical utility.

This paper offers a new theoretical and clinical look at the death drive in connection with the preservative drive. The author elaborates the flaws she sees in Freud's Beyond the Pleasure Principle (1920) and reformulates the transition between Freud's first drive theory and his second one within an implicit object relations theory. Simultaneously with this revised version of drive theory, a structural theory for the realm of healthy self- and object preservation and for pathological or deadened self and object parts is developed, including the devastating effects of trauma. Clinical material from an extended psychoanalysis shows how these concepts can help us understand these patients' absence and "deadness" and rethink the technical challenges they provide.

Adaptation, Psychological↗
PubMed1981

Psychomotor performance and real driving performance of outpatients receiving diazepam.

The primary aim of this study was to compare task performance in a laboratory test and real driving performance of outpatients receiving diazepam medication with those of control subjects. Plasma and saliva samples were taken to investigate a level-response relationship. Real driving performance was measured by trained observers. The design of the laboratory test was based on a vigilance task (high attention) directly followed by a simple eye-hand coordination tasks (low attention). Twenty-two males participated in the study. Diazepam was given orally by prescription, mostly as a maintenance dose of 5 mg three times a day. Patients receiving diazepam showed impaired performance in the driving test and the low-attention task. Furthermore, the results indicate no relationship between plasma or saliva levels of diazepam and/or its metabolite N-desmethyldiazepam and real driving performance and/or laboratory task performance.

Adult↗
PubMed1995

Evaluation of neuropsychological function in patients with liver cirrhosis with special reference to their driving ability.

Ability to drive an automobile was evaluated in 16 patients with well compensated liver cirrhosis. Four tests were performed, namely the emergency reaction test, the continuous emergency reaction test, the signal confirmation test and the accelerator reaction test. Test scores were compared to those of a group of age-matched healthy volunteers. 31% of patients were found to be unfit to drive. Alcoholic cirrhotics fared as poorly as non-alcoholic cirrhotics. In patients with subclinical hepatic encephalopathy (defined by neuropsychologic testing), 44% were unfit to drive. Routine testing of cirrhotic patients for ability to drive could have a major impact on motor vehicle accident rates.

Adult↗
PubMed2000

Parkinson's disease and the ability to drive.

Criteria for assessment of the ability to drive in Germany are based on guidelines published by the Gemeinsamer Beirat für Verkehrsmedizin and incorporated into the legislation. Decisions relating to the ability to drive must always be taken on an individual basis. In parkinsonian patients the ability to drive is very often impaired by motor symptoms, psychiatric complications, multimorbidity, increased daytime sleepiness and especially by cognitive disturbances. Increased daytime tiredness is common in Parkinson's disease with additional sedative effects of all dopaminergic agents (e. g., pramipexole, ropinirole). Unwanted falling asleep (e. g., at the wheel) can be avoided if notice is taken of the early signs of tiredness. A recommendation is included how to advise patients with Parkinson's disease treated with a dopamine agonist regarding the ability to drive.

Automobile Driving↗
PubMed2002

[Psychiatric disorders and fitness to drive an automobile. An overview].

The revised version of the guidelines for driving ability and the new driving license decree in Germany are outlined regarding forensic implications, general rules, and guidelines for psychiatric illness. Patients suffering from acute organic psychosis, severe dementia, acute schizophrenia, mania, severe depression, and alcoholism must be seen as unable to drive cars. Regarding effects of psychotropic medication on driving performance, multiple data with healthy volunteers are available, with very few patients, however. Based on new data showing differences between older and newer antidepressants and antipsychotics, individual drug selection is strongly recommended.

Accidents, Traffic↗
PubMed1999

['Methadone substitution therapy and driving'. Results of an experimental study].

The aim of our experimental study was to gain informations and data on the driving ability of patients undergoing a methadone substitution programme as well as to explore the influence of an HIV infection. 28 patients, five of them HIV-positive, were compared to a control group equal in age, sex and education. For the traffic relevant tests the methadone patients showed significantly reduced performance. Six of the methadone patients passed the tests in a way regarded to have sufficient driving skills. We were unable to prove an influence of HIV infection on driving skills when lacking relevant somatic and neuropsychiatric symptoms. There was no significant correlation between the test results and patients age or dose of medication. We conclude that in general methadone substitution does not implicate driving inability although the majority of our patients showed some reduction of their psychomotoric skills.

Adult↗
PubMed2000

Driving reaction time before and after anterior cruciate ligament reconstruction.

Driving reaction time was studied in 73 patients under anterior cruciate ligament (ACL) reconstruction using a computer-linked automobile simulator. Each patient was tested pre-operatively and 2, 4, 6 and 8 weeks after surgery. Stepping and standing tests were studied at each time point. Twenty-five normal subjects were also tested as controls. Pre-operative test results did not differ significantly between groups on any of the tests. Post-operatively it took 6 weeks for driving reaction time of the right ACL group to be equivalent to that of the controls, compared to 2 weeks in the left ACL group. There was a strong correlation between the stepping and standing tests and the driving reaction time; this made them good clinical tests to monitor patients' progress and to suggest the appropriate time to resume driving.

Adult↗
PubMed1999

Residual effect of zolpidem 10 mg and zopiclone 7.5 mg versus flunitrazepam 1 mg and placebo on driving performance and ocular saccades.

RATIONALE: Studies report contradictory results concerning the residual effects of zolpidem and zopiclone. Moreover, residual effects of these compounds on healthy subjects have not yet been simultaneously assessed. OBJECTIVE: The present study with healthy subjects investigated the residual effects of zolpidem 10 mg and zopiclone 7.5 mg on driving performance and on ocular saccade and compared them to those under flunitrazepam 1 mg and placebo. METHODS: The study involved 16 subjects divided into two groups, a 9:00 a.m. group and a 11:00 a.m. group, in a balanced, double-blind, cross-over design. RESULTS: In the 9:00 a.m. group, zolpidem had no residual effects while zopiclone and flunitrazepam both impaired driving performance (P < 0.001 for both) and increased saccadic latency (P < 0.005; P = 0.052, respectively). Zopiclone impaired driving performance 5 times less than did flunitrazepam. In the 11:00 a.m. group, zolpidem and zopiclone had no residual effects, while flunitrazepam increased saccadic latency (P = 0.065) but did not impair driving performance. CONCLUSIONS: Zopiclone and flunitrazepam had residual effects in the first part of the morning, whereas zolpidem had no residual effects. The hierarchical character of the effects of the molecules differed according to the test administered. This is probably linked more to drug-induced specific alterations than to different sensitivities of the tests.

Adult↗
PubMed2005

Prevention of coordinated eye movements and steering impairs driving performance.

When approaching a bend in the road, a driver looks across to the inside kerb before turning the steering wheel. Eye movements and steering are tightly linked, with the eyes leading, which means that the oculomotor controller can assist the neural centres controlling steering. This optimum coordination is observed for all drivers; but despite being the preferred solution to the motor-control problem of successfully steering along a winding road, the question remains as to how crucial such coordinated eye and steering movements are for driving performance. Twenty subjects repeatedly drove a simulated stage of the World Rally Championship, aiming to complete the course in the fastest possible time. For the first six repetitions they used the usual coordination of eye movements and steering; for drives 7--12 they were instructed to fixate on a small spot in the centre of the screen (centre gaze). Prevention of coordination in this way impaired their performance (drives 6 and 7 compared), dramatically increasing their time taken to complete the course, equivalent to slipping 19 places down the leader board in the actual rally stage. This indicates that the usual pattern of eye movements correlated with steering is crucial for driving performance. Further experiments are suggested to reveal whether any attentional demand associated with keeping the eyes still contributes to the loss in performance.

Adult↗
PubMed2004

Effects of desloratadine, diphenhydramine, and placebo on driving performance and psychomotor performance measurements.

INTRODUCTION: First-generation antihistamines taken for relief of allergic rhinitis are sedating and pose potential risks for those driving a car or operating machinery. Desloratadine is a potent, selective, histamine H(1)-receptor antagonist that does not easily cross the blood-brain barrier. It is nonsedating at therapeutic doses and should not affect driving or psychomotor performance. OBJECTIVE: This study compared the acute effects of desloratadine with diphenhydramine (active control) and placebo on the performance of healthy subjects evaluated with standard over-the-road driving tests (primary objective). The subjects' performances were also evaluated (secondary objective) with the use of conventional performance tests. METHODS: Eighteen men and women received a single dose of desloratadine 5 mg, diphenhydramine 50 mg, or placebo during each period of this randomized, double-blind, three-way, crossover study. Two hours post-dosing, subjects operated a specially instrumented vehicle in a 90-min test designed to measure their ability (1) to maintain constant speed and lateral position while following another vehicle at a constant distance and (2) to respond to brake signals. Additionally, a full battery of performance tests was administered. RESULTS: No significant differences were noted between desloratadine and placebo in standard deviation of lateral position (SDLP), whereas diphenhydramine treatment significantly increased SDLP ( P< 0.001 for both comparisons). Brake reaction time was significantly faster following treatment with desloratadine than diphenhydramine (473.72 ms vs 541.22 ms; P< 0.001) or placebo (512.06 ms; P=0.033). No differences were seen among treatments in deviation of speed or distance to the lead car. The majority of performance tests showed no significant differences among groups. CONCLUSION: Desloratadine at a therapeutic dose does not impair driving performance.

Adult↗
PubMed2004

Effect of different vibration frequencies on heart rate variability and driving fatigue in healthy drivers.

OBJECTIVE: This investigation was to assess the effect of different vibration frequencies on heart rate variability (HRV) and driving fatigue in healthy subjects during simulated driving, by the use of power spectrum analysis and subjective evaluation. MATERIALS AND METHODS: Sixty healthy subjects (29.6+/-3.3 years) were randomly divided into three groups, A, B and C, and the subjects of each group participated in the simulated driving for 90 min with vertical sinusoidal vibration (acceleration 0.05 g) of 1.8 Hz (group A), 6 Hz (group B) and no vibration (group C), respectively. Low-frequency (LF) and high-frequency (HF) components of HRV, reflecting sympathetic and parasympathetic activities, and the LF:HF ratio, indicating sympathovagal balance, were measured throughout all periods. All indices of HRV were calculated in the pre-experiment period, mid-experiment period and end-experiment period, and were analyzed by repeated measures analysis of variance. Subjective responses to a questionnaire were obtained after the simulated task for the three groups. RESULTS: Significant differences in all indices of HRV were observed between different experiment periods and between any two groups. The ratings of subjective fatigue exhibited significant differences between any two groups. CONCLUSION: The drivers' fatigue ratings were associated with vibration frequencies in simulated driving. The study quantitatively demonstrated that different effects on autonomic nerve activities were induced by different vibration frequencies.

Adult↗
PubMed2005

Examining the effects of fatal vision goggles on changing attitudes and behaviors related to drinking and driving.

This study investigated the effectiveness of the Fatal Vision goggles. College students (N = 251) were randomly assigned to one of four groups including two control groups, a group wearing the goggles, and a group watching those wearing the goggles. Attitudes and behaviors toward drinking and driving were assessed immediately prior to and after the intervention, and then again at a four-week follow up. The group wearing the goggles reported significantly greater declines in accepting attitudes toward drinking and driving compared to the other groups at the immediate post-test. However, these differences disappeared after four weeks. Also, the change in attitude was not accompanied by a similar decrease in drunk driving behaviors. Editors Strategic Implications: School and agency administrators, seeking to reduce unacceptably high rates of drinking and driving, will benefit from this well-designed longitudinal experiment. Replication will be necessary, but the authors present strong evidence that this is a prevention strategy that does not result in behavioral change.

Accidents, Traffic↗
PubMed1985

Marihuana and driving.

A review was performed of the marihuana and driving literature, both epidemiological and experimental. It was noted that epidemiological studies face considerable difficulties in obtaining estimates of risks involved for drivers utilizing marihuana due to the rapid decline in blood levels of tetrahydrocannabinol. On the other hand, experimental studies examining the relationship between administered marihuana dose and performance have identified many driving-related areas as exhibiting impairment. Areas impaired include coordination, tracking, perception, vigilance and performance in both driving simulators and on the road. Other behavioral areas of lesser importance for driving also exhibited evidence of impairment by marihuana. Areas for further research are suggested.

Accidents, Traffic↗
PubMed1987

Decisions relating to alcohol-impaired driving: an exploratory analysis.

This paper focuses on an individual's decision to drive or not to drive after drinking. To evaluate this decision, a utility maximizing probabilistic choice model is specified and estimated using a sample of college students. The estimation results provide interesting insights relating to the potential effectiveness of drinking-driving countermeasures, and suggest that the most effective methods of reducing the probability of driving after drinking are those advertising and awareness campaigns that focus on altering individual preferences.

Adult↗
PubMed1988

Female drinking and driving: recent trends in North Carolina.

Data on driver licensing, DWI arrests, crashes, and fatalities in the State of North Carolina from the mid-70s to the mid-80s are analyzed to examine trends in drinking and driving by women. Findings presented are based on rates per licensed driver. Results suggest that more women are driving and are experiencing greater exposure to the hazards of drinking and driving. DWI arrest rates for women increased by 43% while rates for men decreased by 9%. Likewise, the proportion of legally intoxicated drivers among women is increasing. Women account for a growing proportion of alcohol-related (A/R) crashes and their involvement in single vehicle nighttime crashes is increasing. A dramatic decrease was observed in A/R fatalities in the male licensed driving population. This decrease was not paralleled by women. Authors conclude women will make up an increasing proportion of those arrested and convicted for DWI and will have more A/R crashes. Findings have implications for the design and implementation of education, deterrence, enforcement, and rehabilitation programs.

Accidents, Traffic↗
PubMed1988

A three-year prospective study of rearrests for driving under influence of alcohol or drugs.

Fifty drunken drivers and 50 drivers with high blood drug concentrations arrested during the first four months of 1983 were selected for a study of rearrests for driving under influence of alcohol or drugs. Of the drugged drivers selected, 32 had been driving with high blood concentrations of diazepam (greater than 1.0 microM). 50% of these drivers were rearrested during the subsequent three years. The rearrest rate was low (6%) among those who had been driving with high blood concentrations of amphetamine (greater than 2.0 microM) or THC (greater than 0.010 microM). Among the drunken drivers arrested (BAC greater than 0.05%), the rearrest rate was 20%. The drivers were mostly rearrested for driving under the influence of alcohol.

Adult↗
PubMed1991

The effects of mobile telephoning on driving performance.

The effects of telephoning while driving were studied in three different traffic conditions, i.e. in light traffic on a quiet motorway, in heavy traffic on a four-lane ring-road, and in city traffic. Twelve subjects, unfamiliar with mobile telephones, drove an instrumented vehicle for one hour each day during three weeks and while in each of the three traffic conditions, had to operate the mobile telephone for a short while. To ensure a fixed "heavy traffic load" in the second condition, the subjects were instructed to follow another instrumented vehicle (at a safe distance). The results showed a significant effect of telephoning while driving as opposed to normal driving (i.e., not involving telephone conversation), on the effort subjectively measured by an effort scale and objectively measured by heartrate indices and on some of the measured parameters of driving performance. One half of the subjects had to operate the telephone manually, the other half performed the telephone task with a handsfree mobile telephone set. The subjects who operated the handsfree telephone showed better control over the test vehicle than the subjects who operated the handheld telephone, as measured by the steering wheel movements. Also, a clear improvement over time in the course of the 15 test days was found for some of the measurements. As a consequence of the results, some advice concerning mobile telephoning can be given to authorities, manufacturers, and users.

Adult↗