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Consequences of displaying abnormal social behaviour: avoidance and reduction of social reinforcement.

BACKGROUND: Abnormal social behaviour, which is a common feature of psychiatric disorders, is associated with rejection. A passive lack of participation or involvement has been studied as characteristic of depression but active forms of nonparticipation have received little experimental attention. This study examined the interpersonal consequences of four distinct types of social behaviour by using the role enactment method. Two of the roles portrayed abnormal social behaviour, active nonparticipant 'manic' and passive nonparticipant 'sad', and two portrayed normal social behaviour, active participant 'warm' and passive participant 'shy'. METHODS: Sixty-three normal subjects were randomly allocated to a brief dyadic social interaction with a confederate acting one of four roles. Subsequently, they rated their level of rejection of the confederate and took part in the mixed-motive game with him/her. RESULTS: The subjects were more likely to reject confederates in the abnormal social behaviour roles. This was shown on both their nonverbal behaviour and their verbal report. On the mixed-motive game, subjects gave fewer points and less cooperative and ingratiating messages to the confederates who had displayed abnormal social behaviour. LIMITATIONS: This result might only reveal the effects of first impressions of a confederate who behaves in a particular way, but not be generalised to long term acquaintanceship. CONCLUSIONS: These results extend previous findings that passive nonparticipant behaviour leads to rejection to active nonparticipant behaviour and show that the consequences of displaying such behaviour not only result in rejection but also in the reduction of social reinforcement. This might slow a patient's recovery process.

Adolescent↗

Autistic features in Cohen syndrome: a preliminary report.

Cohen syndrome is a rare, genetic, connective-tissue disorder, with the genetic abnormality linked to chromosome 8q22. Its physical features (particular facial characteristics; body, limb, and visual abnormalities; height and weight problems) have been well documented but little is known about the psychological and behavioural development of individuals with the condition. Suggestion of a dual diagnosis of autism in a small minority of individuals led to a more detailed survey of parents belonging to the Cohen Syndrome Support Group, based in the UK. Thirty-three individuals, 18 males and 15 females, aged from 2 to 45 years (mean age 15 years) were involved in the study. Over half of the participants (n=19) showed a pattern of impairments in social and communication skills, together with rigid and stereotyped behaviours or interests that seemed to meet DSM-IV/ICD-10 criteria for autism. 'Autistic-type' problems were as common in females as in males. In almost all cases, parents had noted difficulties in their child before the child reached the age of 1 year. This study suffers from a number of methodological shortcomings including the fact that it was a postal survey, the sample size was small, and no standardized diagnostic or psychometric data were available. However, the incidence of social, communication, and behavioural problems would seem to warrant further research and a larger-scale study is planned in association with an independent investigation of physical and genetic characteristics in the same group of individuals.

Adolescent↗

Achieving gains beyond response.

OBJECTIVE: To review adverse outcomes following response in treatment of depression. METHOD: Review of published literature with particular emphasis on key papers. RESULTS: Moderately high rates of relapse and recurrence are found in naturalistic follow-up studies of depressed patients receiving modern treatment. These are reduced but not abolished in controlled trials by continuation and maintenance treatment with antidepressants. Suicide rates in follow-up studies are much elevated compared with the general population. Social function is impaired and remits more slowly than depressive symptoms. A key outcome is the occurrence of incomplete remission with residual symptoms, which is associated with high relapse rates and impaired social function. CONCLUSION: It is important to achieve complete remission in depression. Elimination of residual symptoms is an important target for full treatment of the depressive episode, in order to avoid later adverse outcomes.

Antidepressive Agents↗

Psychiatric health needs and services before and after complete deinstitutionalization of people with intellectual disability.

Before total deinstitutionalization in Norway, many believed that the ordinary health care system could give people with intellectual disability the same or even better health care than that which they received in institutions. It was said that institutions created psychiatric problems, and that these would diminish or even disappear with the closing of these establishments. The present study is a prospective cohort study without a control group. It examines the frequency of mental health problems and the psychiatric health services which 109 subjects aged between 16 and 65 years received before (1987) and after (1995) deinstitutionalization. Mental health problems were defined as behavioural disturbances, and psychiatric disorders and symptoms. Psychiatric disorders were identified with the Psychopathology Instruments for Mentally Retarded Adults (PIMRA), which were filled in by the carers. Behaviour disturbances were identified as having occurred or not during the previous year. Psychiatric problems remained frequent, and there was a significant increase in behavioural problems in spite of total deinstitutionalization and improved physical living conditions. Access to qualified help, such as psychologists and psychiatrists, had been substantially reduced. Most mental health problems among people with intellectual disability are not solved by reorganization or deinstitutionalization, and such measures are no substitution for professional assistance.

Adolescent↗

Convergent neuroanatomical and behavioural evidence of an amygdala hypothesis of autism.

In this study we report a convergence of behavioural and neuroanatomical evidence in support of an amygdala hypothesis of autism. We find that people with high-functioning autism (HFA) show neuropsychological profiles characteristic of the effects of amygdala damage, in particular selective impairment in the recognition of facial expressions of fear, perception of eye-gaze direction, and recognition memory for faces. Using quantitative magnetic resonance (MR) image analysis techniques, we find that the same individuals also show abnormalities of medial temporal lobe (MTL) brain structure, notably bilaterally enlarged amygdala volumes. These results combine to suggest that developmental malformation of the amygdala may underlie the social-cognitive impairments characteristic of HFA. This malformation may reflect incomplete neuronal pruning in early development.

Adolescent↗

Micturition problems in relation to quality of life in men with prostate cancer or benign prostatic hyperplasia: comparison with men from the general population.

The aim of the study was to investigate men with prostate cancer and benign prostatic hyperplasia (BPH) in comparison with men from the general population in aspects of presence and frequency of micturition problems in remembrance of prior to treatment and currently. Further, the aim was to investigate the impact of micturition problems on quality of life and the association with micturition problems, and quality of life and sense of coherence (SOC). The samples consisted of 155 men with prostate cancer, 131 with BPH, and 129 from the general population. Micturition problems were assessed with study-specific questions, modified International Prostate Symptom Score (IPSS), quality of life questionnare (QLQ C-30), and SOC questionnaires. Parametric and nonparametric statistics were applied. Most troublesome urinary problems were leakage, feelings of discomfort, and disrupted urinary function and frequency. Men with urological diagnosis had more micturition problems, fatigue, and sleeping difficulties than men from the general population, but the cancer diagnosis did not add to the problems. Role and social functioning (prostate cancer), emotional functioning (BPH), and grade of fatigue (general population) showed itself vital for overall quality of life. Thus, help in solving issues of micturition problems, fatigue, and sleeping disturbances may contribute to maintenance of role, social, and emotional aspects of life.

Activities of Daily Living↗

Olanzapine in PDD.

Explore the source record for details and available documents.

Antipsychotic Agents↗

Psychiatric disorders in the context of evolutionary biology. A functional classification of behavior.

This paper examines selected psychiatric illnesses from an evolutionary biological perspective. We present a functional classification of behavior-a classification system concerned with biological goals and behaviors which have biological consequences. The paper begins with an outline of functional views in psychiatry. This is followed by a review of the theoretical framework which serves as the basis for the classification system presented here. Biological goals are then listed and discussed. The capacity of individuals with psychiatric illnesses to achieve biological goals is reviewed briefly. Adaptive behaviors used to pursue the biologically relevant goals are then presented. The relationship between the capacity to enact adaptive behaviors and goal achievement is discussed with particular emphasis on the important role of adaptive strategies as a means of goal pursuit.

Adaptation, Psychological↗

Attention orienting by another's gaze direction in children with autism.

BACKGROUND: The aim of this study was to investigate attention orienting triggered by another's gaze direction in autism. METHOD: Twelve high-functioning children with autism and gender- and age-matched normal control children were studied using two tasks. In the first task, children were asked to detect laterally presented target stimuli preceded by centrally presented facial cue stimuli in which gaze was either straight ahead or averted. The direction of the cue was either congruent, neutral, or incongruent with respect to the laterality of the target stimulus. In the second task, children were asked to discriminate the direction of eye gaze. RESULTS: The results showed that another person's static gaze direction triggered an automatic shift of visual attention, both in children with autism and in normally developing children. The children in both groups were also able to overtly discriminate the direction of the gaze. CONCLUSION: These results seem to suggest that, in children with autism, the visual system processes information about another person's gaze direction and sends this information to those areas that subserve reflexive attention orienting. However, future studies are needed to investigate whether the processing of eyes and gaze direction relies on similar neural mechanisms in children with autism and in normally developing children.

Attention↗

The relationship between mental illness severity and stigma.

OBJECTIVE: To investigate influencing factors for lay perception of mental illness severity and their effects on the stigma of mental illness. METHOD: Selective review including attitude surveys assessing social distance towards different diagnostic labels, and attitudes towards treatment professions, treatment strategies, and psychopharmacotherapy. RESULTS: Lays differentiate in their attitudes towards people with mental illness according to the given diagnostic label, the involved treatment professions or institutions, the applied treatment methods, and the perceived psychosocial disability. CONCLUSION: Beside perceived treatment intensity and diagnostic label, the perception of social disability of mentally ill people accounts for a differentiated stigma. The question arises how anti-stigma-programmes can include the topic of social disability into their messages without risking to strengthen the stigma of mental illness.

Disability Evaluation↗

Acute stress disorder symptoms in gunshot-injured youth.

PROBLEM: The prevalence of acute stress disorder symptoms (ASDS) and other psychiatric comorbidities in youth with recent gunshot injuries. METHODS: Children (n=20) admitted to an urban hospital ER for gunshot injuries over a 4-year period were evaluated for ASDS, co-morbid DSM-III-R diagnoses, legal and gang involvement, and psychiatric history; medically hospitalized children (n=36) similar in age, sex, race, and socioeconomic status served as a control group. FINDINGS: Gunshot-injured youth reported a 75% rate of ASDS compared to a 14% rate in medically ill youth (OR 18.6; chi2 = p < .0001). Parent ratings of ASDS closely corresponded with youth ratings. Youth rated reexperiencing the event as the most frequent distressing symptom. Gunshot injury was associated with legal problems, gang involvement, marijuana/alcohol dependence, conduct disorder, social phobia, and agoraphobia compared to youth with medical illness. CONCLUSIONS: Compared to youth with medical illness, gunshot-injured youth were 18.6 times (p = .0001) more likely to show symptoms of ASDS. Further research, developmentally appropriate assessment, prevention, and treatment are needed in this area.

Adolescent↗

Asperger's syndrome: who is being abused?

Six case histories of children referred and admitted to a psychiatric inpatient unit at a tertiary referral centre because of concerns about poor functioning and possible emotional abuse are presented. On initial assessment the children appeared to be well functioning and the impression was confirmed that their emotional needs were not being met by their parents. After detailed inpatient appraisal the diagnosis of Asperger's syndrome was made in all six cases, exemplified mainly by a formal concrete way of thinking and an inability to identify and understand human emotions and relationships. The impact of the diagnosis on the parents and their consequent relationships with their child and their willingness to work with professionals is discussed.

Affective Symptoms↗

Behavioural phenotype of Cornelia de Lange syndrome.

A postal questionnaire was used to study 49 individuals with Cornelia de Lange syndrome (including both the classical and the mild forms) to ascertain behavioural phenotype. Ages ranged from early childhood to adulthood (mean age, 10.2 years; SD, 7.8) and the degree of mental retardation from borderline (10%), through mild (8%), moderate (18%), and severe (20%) to profound (43%). A wide variety of symptoms occurred frequently, notably hyperactivity (40%), self injury (44%), daily aggression (49%), and sleep disturbance (55%). These correlated closely with the presence of an autistic like syndrome and with the degree of mental retardation. The frequency and severity of disturbance, continuing beyond childhood, is important when planning the amount and duration of support required by parents.

Adolescent↗