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Biomedical subjects

E Turkheimer

Publications and source records attributed to E Turkheimer.

11 recordsLinked to original sources

Touch relieves stress and pain.

There are few systematic investigations of the potential benefits of incidental touch as it occurs in medical health care settings. In the present laboratory study 60 college students participated in two testing sessions 1 month apart. These sessions involved counterbalanced conditions of baseline, pulse palpation (touch), cold pressor test (stressor), and combined cold pressor/pulse palpation. Heart rate and systolic and diastolic blood pressure were measured during each condition. Subjective pain ratings were recorded during stress conditions. Significant decreases in cardiovascular measures and pain ratings were associated with physical contact. However, these changes were small and individual responses to physical contact were not stable over time. Physical contact produces a small but significant decrease in cardiovascular variables and the experience of pain. However, the tendency to show a cardiovascular response to touch does not represent a stable trait for individuals in the laboratory setting.

Adult

Why the gap? Practice and policy in civil commitment hearings.

The failure of civil commitment procedures to meet statutory requirements is one of the more reliable findings in the applied social sciences. Most states now require specific legal procedures and behavioral standards for involuntary hospitalization. Nonetheless, empirical studies have demonstrated that commitment hearings are rarely adversarial and clinical concerns continue to take precedence over legal issues. These findings are analyzed in the context of three related issues: the grounds for commitment that are used in civil commitment hearings, the particular difficulties of recommitment hearings, and the shortcomings of the national policy of deinstitutionalization. The authors conclude that a primary cause of the gap between legal standards and actual practice is the absence of viable, less restrictive alternatives to inpatient treatment.

Commitment of Persons with Psychiatric Disorders

Length of hospitalization and outcome of commitment and recommitment hearings.

Despite extensive legislative reformulation of civil commitment procedures, empirical studies have shown that civil commitment hearings continue to be largely nonadversarial. The authors observed all civil commitment hearings during a three-month period at a large state hospital in Virginia and examined the characteristics of patients and the actions of attorneys, clinical examiners, and judges as a function of the length of time the patient had been in the hospital. The analysis revealed that as the length of a patient's hospitalization increased, the hearings became shorter and less adversarial; patients tended to show fewer signs of acute psychiatric illness and more signs of chronic schizophrenia. The implications of these findings for civil commitment policy are discussed.

Commitment of Persons with Psychiatric Disorders

Basic relations among lesion laterality, lesion volume and neuropsychological performance.

Although it is widely accepted that lesion size is an important determinant of severity of deficit, difficulties in the quantification of lesion size and the absence of a theoretical model of how lesion volume combines with lesion locus to produce deficits have inhibited the development of methodological and statistical procedures for studying naturally occurring lesions in humans. We propose such a unified model and apply it to the analysis of neuropsychological performance in a sample of patients with naturally occurring unilateral lesions. The analysis suggests that a statistical interaction between lesion size and laterality may be an important determinant of neuropsychological deficit.

Adult

Quantitative assessment of covariation between neuropsychological function and location of naturally occurring lesions in humans.

Studies of localization of brain function in humans depend on analysis of covariation between the location of naturally occurring lesions and measures of neuropsychological ability. Such an analysis presents two problems: how to represent numerically the infinite variety of lesion locations, sizes, and shapes; and how to assess covariation between the location measure and performance. We present a mathematical model of lesion location and its relationship with performance. To demonstrate its utility, the model is applied to a sample of 53 patients with naturally occurring brain lesions who were administered a standard battery of neuropsychological tests. Importance functions derived for the neuropsychological measures generally conform to expectations. Sensory and motor abilities were localized correctly within the contralateral hemispheres, and language functions were localized in the left frontal region. Lesion location accounts for substantially more variation in performance than does lesion volume, with location accounting for more than 50% for some left-hemisphere functions.

Brain

Morphological brain abnormalities in schizophrenia determined by computed tomography: a problem of measurement?

The size of the cerebral ventricles was estimated from computed tomographic (CT) scans of 14 young patients with schizophrenia and 12 medical controls. The subjects were a representative subsample from a larger sample studied by Boronow et al. (1985). Although no CT abnormalities were detected in the psychiatric patients using traditional measures (mechanical planimetry for the lateral ventricles and a linear measure for the third ventricle), a volumetric analysis of the same 26 scans revealed enlargement of the lateral and third ventricles in the schizophrenics. The effect revealed by volumetric measures of the lateral ventricles was 58% greater than that obtained with digital planimetry and 96% greater than the effect found using mechanical planimetry. No differences were found between volumetric and digital planimetric measures of the third ventricle, but the effect revealed by the latter measure was 114% greater than that obtained by a linear index. It is suggested that volumetric measures of lateral ventricles based on information from several CT slices may be more sensitive to group differences in ventricular size than planimetry. Likewise, area measures of the third ventricle may be more sensitive to group differences than linear measures.

Adolescent

Volumetric asymmetries of the human brain: intellectual correlates.

Volumetric measures of the brain and ventricles were derived from CT films and related to intellectual variables from the Wechsler Adult Intelligence Scale (WAIS). Subjects were patients referred for neurological examination for headache or somatic complaints, sometimes accompanied by anxiety or dysphoric affect (N = 41), for whom a comprehensive neurological work-up revealed no evidence of abnormality. The asymmetry of hemispheric volume (left minus right over total, times 100) was correlated (r = .57, p less than .001) with Verbal IQ minus Performance IQ within subjects. No relationship was observed between total brain or hemispheric volumes and IQ scores. Brain and ventricular volumes were larger for the left hemisphere than the right.

Brain

Relationship between cognitive and morphological asymmetry in dementia of the Alzheimer type: a CT scan study.

In this study we investigated the association between morphological asymmetry and patterns of cognitive ability in dementia of Alzheimer's type (DAT). Digitized CT scans were used to estimate volumetric parameters of the brain. The volume of the cranium, brain parenchyma, the subarachnoid space, and lateral ventricles was computed. The volume of the subarachnoid space was used as an index of cortical atrophy, while the ventricular volume served as an estimate of subcortical atrophy. Asymmetry indices were computed for all structures as the difference between left and right volume divided by their average and multiplied by 100. Cognitive asymmetry index was computed by dividing the difference between VIQ and PIQ of the Wechsler Adult Intelligence Scale (WAIS) by their average and multiplying by 100. After statistically controlling for cranial asymmetry, hemispheric asymmetry was found to correlate positively with cognitive asymmetry. The correlation was somewhat greater for male than for female patients. Asymmetry of both cortical and subcortical atrophy correlated negatively with cognitive asymmetry.

Aged

Intellectual and memory impairment in dementia. Computerized axial tomography volume correlations.

Ventricular volume estimates and an index of cerebral atrophy were obtained from computerized axial tomography scans of patients with presenile or senile dementia of probable Alzheimer's type. These measures were used to examine the correlation between morphological brain change and performance on the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (WMS). Despite ventricular volumes in excess of 60% larger than normal, no significant correlations were found between ventricular size and WAIS or WMS performance. The index of pericerebral atrophy did correlate negatively with various WAIS measures, particularly Performance IQ, and some aspects of WMS performance. Results suggest that in Alzheimer's disease, pericerebral atrophy measures, but not ventricular dilation, correlate with intellectual decline and certain aspects of memory impairment.

Aged

Quantifying cortical atrophy.

Most of the methods of quantifying cortical atrophy that have been proposed involve the estimation of the volume of enlarged sulci in the cerebral cortex. The authors propose that the surface area of the sulci is a more valid measure of cortical atrophy, and describe a system for measuring the surface area of the cortex, and present data in support of the method's reliability and validity.

Adult