The treatment of affects: an interdisciplinary issue.
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Adult↗
Biomedical subjects
D Widlöcher
Publications and source records attributed to D Widlöcher.
Investigating theory of mind in schizophrenia: influence of verbalization in disorganized and non-disorganized patients.
The ability to attribute intentions to others was studied in 13 disorganized and 13 non-disorganized schizophrenic patients, 13 depressed and 13 normal controls. Subjects were asked to complete 28 comic strips requiring theory of mind skills by choosing one out of three answer cards. The answer cards were simple pictures in a first condition and short sentences in a second condition. This study, which used the cognitive neuropsychological approach, underlies the existence of a link between disorganization patterns in schizophrenia and a deficit in the attribution of intentions to others, independently of the pictorial or verbal form of the mode of answering. In addition, results show that the non-disorganized schizophrenic group, depressed and normal controls perform similarly in both pictorial/verbal conditions. The influence of the absence/presence of verbal material on a task investigating theory of mind in schizophrenia is discussed.
Adult↗
Impairment of semantic categorization processes among thought-disordered schizophrenic patients.
OBJECTIVE: To explore semantic categorization strategies in patients with schizophrenia. METHOD: A short-term memory-recognition task that reveals the effects associated with categorization was created and applied to 2 groups of patients with schizophrenia and depression. RESULTS: Only the schizophrenic subgroup with formal thought disorder (measured using Andreasen's Thought, Language, and Communication [TLC] scale) exhibited a deficiency in semantic categorization strategies during the task. CONCLUSION: These results support the hypothesis of the impairment of the processes involved in the processing of contextual information in patients with schizophrenia who suffer from formal thought disorder.
Adult↗
Quality control, condensed analysis and ethics.
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Clinical Competence↗
Attribution of intentions to others in people with schizophrenia: a non-verbal exploration with comic strips.
Several clinical and experimental data suggest that some people with schizophrenia have an impaired ability to attribute relevant mental states to other people. We tested this notion in 24 schizophrenic patients and two control groups, who performed a task devised to test understanding of the intentions of nonverbal comic strip characters. Only the schizophrenic subjects with thought and speech disorganization had specific difficulties attributing mental states to others. The findings support cognitive models which postulate a link between planning process disorders and a deficit in mentalizing skills. The hypothesis that the more frequent an action is in everyday life, the more easily it is understood by schizophrenic subjects, is discussed.
Adolescent↗
Heterogeneity in cognitive functioning of schizophrenic patients evaluated by a lexical decision task.
BACKGROUND: The disorganization pattern in schizophrenia, which involves formal thought disorders, is thought to be correlated with a deficit in integrative processes of contextual information. We tested the hypothesis that thought disordered schizophrenics, unlike non-though disordered schizophrenics, would present a deficit in the processing of the context during a task which involves these integrative processes. METHODS: A group of 22 schizophrenic patients diagnosed in accordance with DSM-III-R criteria and a group of 11 control subjects were compared using a semantic priming version of the lexical decision task. The experimental design used low-level structuration of verbal material to reveal the difficulty that schizophrenic patients encounter in using semantic regularities. RESULTS: A significant difference in priming effect was found between the three groups. Control subjects and non-thought disordered schizophrenics exhibit a priming effect for related word pairs when compared with unrelated pairs (respectively F(1,10) = 17.7; P < 0.002 and f(1,10) = 14.5; P > 0.003) but thought disordered schizophrenics did not (F(1,10) < 1; NS). CONCLUSIONS: This finding provides evidence for the cognitive heterogeneity of schizophrenic subjects. This absence of priming effect in thought-disordered schizophrenic subjects supports the hypothesis that these patients present a deficit in the post-lexical controlled information processing that permits the integration of semantic information.
Adult↗
Attention deficits in depression: an electrophysiological marker.
EVENT-RELATED POTENTIALS were recorded in young depressed subjects and compared with results from controls. Subjects were required to respond to targets (rare high-frequency sounds) presented to a designated ear, and to ignore targets presented to the non-designated ear as well as standards (frequent low-frequency sounds) presented to either ear. The results confirm those previously obtained with elderly depressed patients, showing the same general profile of electrophysiological and behavioural differences, and in particular a substantial reduction of the N200 amplitude in response to attended targets in depressed subjects. It is suggested that the N200 component could be a marker of depression.
Adult↗
[Dissociative hysteria].
Under the term of dissociative hysteria are described a set of clinical syndromes characterized by behavioral disorders and psychic activity anomalies. The nature of the symptoms seems very similar to hysterical conversion. Psychogenic amnesia, psychogenic fugues and multiple personality disorder are described. There is some evidence that the symptoms are related to psychic affective traumatisms and no physiological alteration. Two mechanisms are proposed: dissociation of personality and amnesia. Clinical course generally improves spontaneously. Various forms of psychotherapy may be used.
Amnesia↗
Decrease of complexity in EEG as a symptom of depression.
Nonlinear dynamic analysis provides new methods for the processing of the electroencephalogram (EEG). We demonstrate here that the EEG dynamics of major depressive subjects is more predictable, that is less complex, than that of control subjects. Moreover, the consequence of treatment upon the EEG dynamics seems to be dependent on the appearance of the illness. Although the specificity of this dynamic signature for different stages of depression is to be confirmed, the assumption of a strong link between a healthy system and a high level of complexity in dynamics is further supported.
Adult↗
Circadian pattern of motor activity in major depressed patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course.
The 24-hour motor activity pattern was evaluated in 26 inpatients with major depression at treatment onset and after 4 weeks of antidepressant therapy. Clinical state, depression, and psychomotor retardation, as well as motor activity level and circadian rhythm, were simultaneously assessed. Treatment responders and nonresponders were also considered. Diurnal hypoactivity and reduced 24-hour rhythm amplitude were found at treatment onset. Activity level increased significantly on discharge. The rest-activity cycle for each depressed patient fit a cosine function of 24-hour periodicity. Data tended to show no phase shift but a large intragroup phase variability. Preliminary findings of a negative correlation between basic activity level and clinical improvement, and a trend toward responders having a lower activity level than nonresponders, suggest that activity could be used to predict therapeutic response.
Adult↗
Loss of control of pre-motor activation in anxious agitated and impulsive depressives. A clinical and ERP study.
1. Current research uses a variety of traditional validation methods in order to test the clinical expression of biological models in psychiatry. The application of these methods has resulted in a paradoxical situation which requires the definition of new objectives in biological and pharmacoclinical research: the biological specificity of new psychotropic drugs does not assume any congruence between their pharmacological and their therapeutic effects, but raises the question of the relationship between biological systems and clinical symptomatology. The dimensional description of psychopathological disorders may be more appropriate to biological studies in psychiatry. 2. A study was undertaken on a population of twenty-one in-patients fulfilling the DSM III-R criteria for major depressive episode. They were divided into two groups on the basis of contrasting clinical dimensions: anxious-agitation and impulsiveness versus retardation and affective blunting. 3. Significant clinical differences between the two groups on mood profiles were echoed by contrasts in event-related potentials during a go-nogo task: only anxious agitated and impulsive patients developed an abnormal cortical activity, as measured by contingent negative variation (CNV), in the nogo condition. 4. This paper suggests how a paradigm with control of motor action leads to specify premotor activation abnormalities in the agitated impulsive depression subtype.
Adult↗
Nicotine dependence and motives for smoking in depression.
Smoking variables were assessed in female (n = 48) and male (n = 28) French hospitalized depressed smokers. Nicotine dependence, motives for smoking, and emotional situations in which depressed smokers were likely to smoke were compared with those of female (n = 36) and male (n = 60) nondepressed smokers from the general population. Depressed smokers scored higher than controls on nicotine dependence, and on stimulant and sedative smoking; they also reported that they were more likely to smoke in negative emotional situations. Sedative smoking decreased significantly between admission and discharge. Sedative smoking is a strong reason for smoking among depressed smokers regardless of degree of dependence, whereas stimulant smoking is positively correlated with degree of dependence. Nicotine dependence is also significantly correlated with anhedonia, and its relationship to depression is discussed in regard to nicotine action on hedonic systems.
Adult↗
A case is not a fact.
Why do we publish clinical data? Between the scientistic illusion that assumes that cases are objective data and the disillusioned observation that psychoanalytic literature is mainly used to boost identity feelings, what role is played by such publications? New psychoanalytical knowledge results from clinical practice and not from scientific experiments or observations. A clinical vignette, even more than a full monograph, is clearly not designed to prove a theory from objective facts but to illustrate a particular clinical view. The quality of a case report relies on at least three criteria: data economy; adequacy to the proposed thesis; and convincingness or persuasion. A case is not a fact, because understanding it presupposes 'semantic holism': understanding any mental state requires taking into consideration a 'world of knowledge'. Empathy results from an unlimited work of inferences. In presenting a case, the psychoanalyst is always in a sense a 'thought-reader'. He describes what he believes he discovers.
Authorship↗
[Psychological theories on the vulnerability to depression].
The problem of psychological vulnerability refers back to the dysymetric interactions between biological, life-event and personality factors. The term "personality" must be defined in terms of three factors: differential characteristics of the primary traits, "temperament" from the purely biological stand-point, and psychodynamic organization. The following discussion will deal solely with notions of temperament and psychodynamic organization. The renewed interest in the notion of temperament for the constitution of depression has been evoked in a number of recent studies, and allows an integrative approach of the biological phenomena. From the stand-point of psychodynamic organization, we should be less concerned with a strictly etiological role than with the mechanisms involved: loss of the object, in the neurotic model (depressive neurosis?) absence of the object (severe narcissistic disorders). This psychodynamic clinical approach must also take into account the triggering or unmasking effects of the depressive state itself on the underlying personality structure.
Depressive Disorder↗
Inverse evolution of emotional blunting and irritability after delivery.
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Affective Symptoms↗
Ascending-descending threshold difference and internal subjective judgment in CFF measurements of depressed patients before and after clinical improvement.
The purpose of this study was to measure, using the method of limits, the ascending-descending threshold difference, delta = fa-fd, in subjects with major depression. 28 patients were given two sessions, one before treatment and the other after recovery. Mean values of delta measured in the second session were significantly smaller than those scored before treatment. The two sets of values were positively correlated. The ascending-descending threshold difference was suggested previously as likely related to the internal subjective judgment of subjects. The present results are consistent with the hypothesis of a more conservative response criterion in depressed patients before than after clinical improvement.
Adult↗
[Emotional disorders in HIV infection].
Psychiatric and neurological symptoms have been the target of many studies, but the emotional and behavioral modifications in HIV infection remain quite unknown. Working on the emotional dimensions and the heterogeneity of depressive mood, we were interested in evaluating the emotional symptomatology in HIV infected patients. Fifteen HIV-positive and fifteen HIV-negative homosexual men paired by age and educational level were studied. They were seen by two trained psychologists who assessed depression, anxiety and mood dimensions with the MADRS depression scale, Covi's anxiety scale, Depressive Mood scale, Abrams and Taylor scale for Emotional Blunting and Retardation scale. HIV-positive subjects had significantly higher scores of emotional blunting: anhedonia and hypoexpressiveness. Scores of depression, anxiety, irritability and hyperexpressiveness were not significantly different between both groups. Hypoexpressiveness scores were correlated to the CDC stages of the disease. This means that the emotional deficit seems to increase with the course of the disease, and is present in the absence of depression or anxiety. The question of the origin of this emotional blunting can be raised: is it the result of an adaptative behavior and/or the action of the virus on the central nervous system? Further studies are needed to confirm these results and answer this question.
Adaptation, Psychological↗
[Post-partum blues: a critical review of the literature].
The abundant literature dealing with the post partum blues has failed to describe a possible causing factor in these emotional and physical manifestations which are frequently observed in mothers during the first few days following delivery. The post partum blues has been considered as a promising model for depressive states but its function has never been clearly established. No agreement has been reached as to its physiological mechanism. Presently there is a renewed interest for the "third day blues" in relation to post-birth depression, which is known to be frequent, and to the early interactions. The authors present a review of the literature and emphasize the necessity to approach this issue from a new standpoint and with new conceptual and measurement tools. The role of post partum blues could well be, through a biological process involving the dopamine, to facilitate the establishment of early mother-infant bonds by provoking a decrease in blunted affect.
Affect↗