Recovered memories of childhood sexual abuse.
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Child↗
Biomedical subjects
H G Pope
Publications and source records attributed to H G Pope.
Eye movement desensitization and reprocessing in eating disorders: caution against premature acceptance.
OBJECTIVE: Eye movement desensitization and reprocessing (EMDR) has been claimed effective in the treatment of a wide variety of psychiatric disorders, including eating disorders. An informal survey suggests that EMDR is now widely offered to patients with eating disorders. Before accepting a new therapy such as EMDR, one must determine that its benefits outweigh its adverse effects. This paper reviews the literature in an attempt to assess the benefits and risks of the use of EMDR in the treatment of eating disorders. METHOD: We reviewed the literature on the use of EMDR to treat eating disorders and other conditions. RESULTS: Looking at the question of its benefits, we were unable to find any methodologically sound studies that have shown efficacy for EMDR in eating disorders, or, indeed, any psychiatric disorder. We were also unable to find a sound theoretical basis for expecting EMDR to be effective. In addition, EMDR may have adverse effects. First, EMDR is sometimes used in conjunction with efforts to "recover" memories of traumatic events. But "recovered memory" therapy may carry a risk of inducing potentially harmful false memories. Second, use of EMDR may prevent or delay other therapies of established efficacy for eating disorders, such as cognitive behavioral therapy and antidepressants. DISCUSSION: In light of the findings of our review, the risk/benefit ratio of EMDR does not as yet encourage its widespread acceptance.
Desensitization, Psychologic↗
Treatment of neuroleptic-induced akathisia with nicotine patches.
We administered 14 mg nicotine patches to 16 patients, all non-smokers, who displayed akathisia from antipsychotic drugs. On single-blind ratings, akathisia appeared significantly reduced on days when patients were wearing the patches as compared to the baseline day. These findings, if confirmed, may help to explain the high rates of tobacco use among psychotic patients, and may suggest avenues for the treatment of akathisia.
Administration, Cutaneous↗
Evidence for a sex-specific residual effect of cannabis on visuospatial memory.
BACKGROUND: In an exploratory study, we used a novel computerized battery of neuropsychological tests of attention to assess residual cognitive impairment in marijuana users. METHODS: We compared 25 college students who were heavy marijuana smokers (who had smoked a median of 29 days in the last 30 days) with 30 students who were light smokers (who had smoked a median of 1 day in the last 30 days). All subjects were tested after a supervised period of abstinence from marijuana and other drugs lasting at least 19 h. RESULTS: Differences between the overall groups of heavy and light smokers did not reach statistical significance on the four subtests of attention administered. However, upon examining data for the two sexes separately, marked and significant differences were found between heavy- and light-smoking women on the subtest examining visuospatial memory. On this test, subjects were required to examine a 6 x 6 'checkerboard' of squares in which certain squares were shaded. The shaded squares were then erased and the subject was required to indicate with the mouse which squares had formerly been shaded. Increasing numbers of shaded squares were presented at each trial. The heavy-smoking women remembered significantly fewer squares on this test, and they made significantly more errors than the light-smoking women. These differences persisted despite different methods of analysis and consideration for possible confounding variables. CONCLUSIONS: This observation suggests that it may be important to study the residual effects of marijuana on men and women separately-particularly since women have been greatly underrepresented in previous studies in this area.
Adolescent↗
Eating disorders in Austrian men: an intracultural and crosscultural comparison study.
BACKGROUND: We compared 30 male university students with eating disorders and 30 male comparison subjects without eating disorders recruited by advertisement at Innsbruck University, Austria. METHODS: Subjects were interviewed using instruments that we had previously used in a controlled study of college men with eating disorders in the United States. RESULTS: The Austrian men with eating disorders differed sharply from Austrian comparison subjects, but closely resembled their American counterparts, on prevalence of personal and familial psychopathology, adverse family experiences, and scores on rating scales for eating disorder. Interestingly, dissatisfaction with body image was consistently greater among American subjects regardless of eating disorder status. CONCLUSIONS: Our data suggest a weak association between eating disorders and homosexual or bisexual orientation in men and no consistent association between eating disorders and childhood sexual abuse.
Adolescent↗
Unusual flashbacks in a Vietnam veteran.
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Combat Disorders↗
Debating dissociative diagnoses.
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Attitude of Health Personnel↗
Drug use history and criminal behavior among 133 incarcerated men.
The present study investigated the relationship between crime and substance abuse in a sample of 133 consecutively evaluated male prisoners. Using the Structured Clinical Interview for DSM-III-R, we assessed the prevalence of various forms of substance abuse in this population and attempted to judge whether substance abuse played a role in the index crime which has led to the present incarceration. In addition, we assessed whether there was a relationship between the nature of substance dependence and the type of crime committed, whether sexual, violent, or non-violent. Among the 133 prisoners, 95% obtained a diagnosis of dependence on one or more substances. Fifty-eight percent of the inmates reported that they were acutely intoxicated with one or more substances at the time they committed the index crime and an additional 6% were withdrawing from a substance at the time of the crime. There was no significant correlation between the type of substance abuse diagnosis and the type of crime committed. Similarly, there was no significant correlation between the number of individuals who reported they were intoxicated at the time of the offense and the type of crime committed.
Adolescent↗
Drug use and lifestyle among college students in Austria and the United States.
Using an anonymous questionnaire, we assessed the prevalence of alcohol use and illicit drug use among 545 college students in Innsbruck, Austria in 1995. The questionnaire also assessed various aspects of students' lifestyles, including academic performance, college activities, career plans, visits to a psychiatrist, and sexual activity. We compared these results with those obtained using the same questionnaire at a similar American college in 1989. We found that the prevalence of virtually all forms of illicit substance use was much higher among the American students. In both Austria and the United States, however, we found few differences between drug users and nonusers on most measures of lifestyle, with the exception of hetero-sexual activity.
Adult↗
Very long-term users of marijuana in the United States: a pilot study.
The authors recruited a sample of 37 Americans, aged 30-74, who had smoked marijuana on at least 5,000 separate occasions. These subjects were found to span a wide range of ethnic groups, educational backgrounds, occupations, and annual income; they did not display any obvious features which distinguished them from the population as a whole. They typically began smoking in the 1960s or early 1970s, and then continued to smoke heavily into middle adulthood because they felt that marijuana relieved unpleasant feeling states such as anxiety or depression. To our knowledge, individuals of this type have not previously been examined; further studies of older, long-term American marijuana users are needed.
Adult↗
Neuropsychological aspects of lack of insight in bipolar disorder: a preliminary report.
In 16 inpatients with acute mania, neuropsychological evaluation revealed a trend toward correlation between less insight (lower scores on the Insight and Treatment Attitudes Questionnaire, ITAQ) and improved delayed visual recall. This result may either reflect the absence of a relationship between neuropsychological abnormalities and lack of insight in bipolar disorder, or it may represent an indirect expression of frontal lobe dysfunction. Also, an association was found between increased number of previous hospitalizations and greater insight. Since the neuropsychological result noted above was limited to patients with more than six previous hospitalizations, an interaction may exist between number of previous hospitalizations and neuropsychological abnormalities in the development of insight.
Adult↗
Is postictal electrical silence a predictor of response to electroconvulsive therapy?
Electroconvulsive therapy (ECT) is an established effective treatment modality for patients with severe depression. Recent studies have focused on developing predictors of response. In this prospective study, using percent decrease in Hamilton Depression Scale (21 items) as the outcome measure, we blindly evaluated 33 inpatients with major depression to determine whether postictal suppression, the electrical silence following induced seizure, would predict treatment response to ECT. A significant relationship was observed between degree of postictal suppression and likelihood of clinical improvement. Postictal suppression should be explored in more controlled studies as a predictor of ECT response.
Brain↗
The residual cognitive effects of heavy marijuana use in college students.
OBJECTIVE: To assess whether frequent marijuana use is associated with residual neuropsychological effects. DESIGN: Single-blind comparison of regular users vs infrequent users of marijuana. PARTICIPANTS: Two samples of college undergraduates: 65 heavy users, who had smoked marijuana a median of 29 days in the last 30 days (range, 22 to 30 days) and who also displayed cannabinoids in their urine, and 64 light users, who had smoked a median of 1 day in the last 30 days (range, 0 to 9 days) and who displayed no urinary cannabinoids. INTERVENTION: Subjects arrived at 2 PM on day 1 of their study visit, then remained at our center overnight under supervision. Neuropsychological tests were administered to all subjects starting at 9 AM on day 2. Thus, all subjects were abstinent from marijuana and other drugs for a minimum of 19 hours before testing. MAIN OUTCOME MEASURES: Subjects received a battery of standard neuropsychological tests to assess general intellectual functioning, abstraction ability, sustained attention, verbal fluency, and ability to learn and recall new verbal and visuospatial information. RESULTS: Heavy users displayed significantly greater impairment than light users on attention/executive functions, as evidenced particularly by greater perseverations on card sorting and reduced learning of word lists. These differences remained after controlling for potential confounding variables, such as estimated levels of premorbid cognitive functioning, and for use of alcohol and other substances in the two groups. CONCLUSIONS: Heavy marijuana use is associated with residual neuropsychological effects even after a day of supervised abstinence from the drug. However, the question remains open as to whether this impairment is due to a residue of drug in the brain, a withdrawal effect from the drug, or a frank neurotoxic effect of the drug. from marijuana
Adult↗
Improved method of detection of testosterone abuse by gas chromatography/combustion/isotope ratio mass spectrometry analysis of urinary steroids.
The current approach to detection of doping with testosterone is based on measuring the testosterone to epitestosterone ratio (T/E) in urine by gas chromatography/mass spectrometry. The median T/E for healthy males who have not used T is about 1.0. In a single urine, a T/E lower than six leads to a negative report even though it does not exclude T administration. A value greater than six indicates possible T administration or a naturally elevated ratio. It has been shown previously that the carbon isotope ratio of urinary T changes after T administration. In this study a potential confirmation method for T abuse was optimized. Gas chromatography/combustion/carbon isotope ratio mass spectrometry (GC/C/IRMS) was used to analyze two T precursors (cholesterol and 5-androsten-3 beta, 17 beta-diol) and two T metabolites (5 alpha- and 5 beta-androstane-3 alpha, 17 beta-diol) in addition to T itself in each of 25 blind urines collected from eight healthy men before, during or after T administration. The carbon isotope ratios of T and the metabolites were lower after T administration. The relationships among the variables were studied using multivariate analysis and beginning with principal components analysis; cluster analysis revealed that the data are composed of two clusters, and classified the samples obtained after T administration in one cluster and the remainder in the other; discriminant analysis correctly identified T users. The measurement of carbon isotope ratios of urinary androgens is comparable to the T/E > 6 test and continues to show promise for resolving cases where doping with T is suspected.
Adult↗
"Recovered memory" therapy for eating disorders: implications of the Ramona verdict.
"Recovered memory therapy" for eating disorders and other psychiatric conditions seeks to help the patient recover repressed memories of childhood sexual abuse and other traumatic experiences. Through this technique, it is hoped that the patient can work through these experiences to achieve relief from shame, body dissatisfaction, and symptoms of depression and eating disorders. However, this method was questioned in the recent Ramona case, where a father successfully sued two therapists and a hospital for allegedly implanting false memories of childhood sexual abuse in his bulimic daughter. The testimony and verdict in this case recall the principle of primum non nocere: Although it is clearly reasonable to consider an unproven therapeutic technique in an attempt to relieve human suffering, the potential risk of the technique--in this case the possible induction of false incest memories--must be weighed carefully against the technique's expected benefits.
Adult↗
Bulimia nervosa in Austria and the United States: a controlled cross-cultural study.
OBJECTIVE: We sought to compare the features of bulimic subjects in two countries (Austria and the United States). METHOD: To assess how bulimia nervosa presents in different cultural settings, we interviewed 33 women recruited from the University of Innsbruck, Austria, who met DSM-III-R criteria for bulimia nervosa and 33 bulimic women recruited from two universities in Massachusetts. Preliminary results on these bulimic groups have previously been reported. The present study adds a control group of 33 Austrian women and 33 Boston women who were recruited and interviewed by identical methods. RESULTS: Bulimic women in both countries proved significantly distinguishable from controls on eating behavior, attitudes toward body shape and weight, lifetime prevalence of major mood disorder, and a few variables regarding childhood experiences. In addition, we found several marked differences between Austria and the United States which appeared independent of the diagnosis of bulimia nervosa. The most prominent of these were satisfaction with body image and levels of substance abuse. CONCLUSIONS: Bulimia nervosa appears to exhibit stereotypic "core" features which are independent of culture, but it has other features which may influenced by underlying cultural differences.
Adult↗