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Biomedical subjects

L Sloman

Publications and source records attributed to L Sloman.

At least 19 recordsLinked to original sources
PubMed2003

Evolved mechanisms in depression: the role and interaction of attachment and social rank in depression.

Evolved mechanisms underpinning attachment and social rank behavior may be the basis for some forms of major depression, especially those associated with chronic stress. We note the heterogeneity of depression, but suggest that some of its core symptoms, such as behavioral withdrawal, low self-esteem and anhedonia, may have evolved in order to regulate behavior and mood and convey sensitivity to threats and safety. Focusing on the evolved mental mechanisms for attachment and social rank helps to make sense of (1) depression's common early vulnerability factors (e.g., attachment disruptions, neglect and abuse), (2) the triggering events (e.g., loss of close relationships, being defeated and/or trapped in low socially rewarding or hostile environments), and (3) the psychological preoccupations of depressed people (e.g., sense of unlovableness, self as inferior and a failure). This focus offers clues as to how these two systems interact and on how to intervene.

Achievement↗
PubMed2001

Clomipramine versus haloperidol in the treatment of autistic disorder: a double-blind, placebo-controlled, crossover study.

Clomipramine, haloperidol, and placebo were compared with baseline in the treatment of autism, and overall outcome, specific symptoms, and side effects were examined. It was hypothesized that clomipramine would be better tolerated than haloperidol and prove superior on a measure of stereotypy. Individuals with a DSM-IV diagnosis of autistic disorder (mean age, 16.3 years; range, 10-36 years) were randomly assigned, by using a Latin square design, to the following 7-week trials: placebo, clomipramine (mean daily dose, 128.4 mg; range, 100-150 mg), or haloperidol (mean daily dose, 1.3 mg; range, 1-1.5 mg). Data on 36 subjects were analyzed and taken together; the results favored haloperidol. In those patients who were able to complete a full therapeutic trial, clomipramine proved comparable to haloperidol in terms of improvement compared with baseline. However, significantly fewer individuals receiving clomipramine versus haloperidol were able to complete the trial (37.5% vs. 69.7%, respectively) for reasons related to both side effects and efficacy or behavior problems. In the intent-to-treat sample, which is perhaps more clinically relevant, only haloperidol proved superior to baseline on a global measure of autistic symptom severity, as well as specific measures for irritability and hyperactivity. Clomipramine did not seem more effective on a measure of stereotypy, nor was it better tolerated.

Adolescent↗
PubMed1998

An open trial of risperidone in young autistic children.

OBJECTIVE: To assess the benefits and side effects of risperidone in young autistic children. METHOD: In this open, prospective trial, subjects were treated with risperidone for 12 weeks. All subjects were started at 0.5 mg daily with individual titration to a maximum of 6 mg or 0.1 mg/kg daily. Behavioral ratings, completed by the investigators and the children's parents, included the Clinical Global Impressions (CGI), Children's Psychiatric Rating Scale, Conners Parent-Teacher Questionnaire, Childhood Autism Rating Scale, and Abnormal Involuntary Movement Scale. RESULTS: Ten boys, aged 4.5 to 10.8 years, were enrolled in the study and all completed the 12-week protocol. The mean final dose was 1.3 mg/day (range = 1 to 2.5 mg/day). On the basis of CGI-rated improvement, 8 of the 10 children were considered to be responders. Improvement was also demonstrated on the other scales. Transient sedation was common, and the children gained an average of 3.5 kg over the 12 weeks of the study. There was no evidence of either extrapyramidal symptoms or tardive dyskinesia. CONCLUSIONS: These results suggest that risperidone may be safe and leads to improvements in several behavioral symptoms in young children with autism. Controlled studies of risperidone in young autistic children are warranted.

Antipsychotic Agents↗
PubMed1998

47,XYY karyotypes and pervasive developmental disorders.

OBJECTIVE: The presence of a 47, XYY karyotype in boys with pervasive developmental disorders (PDDs) has rarely been described in the past. Herein, 2 boys with PDDs and a supernumerary Y chromosome are presented. METHODS: The case histories of the 2 patients are described along with the results of associated testing. The literature on psychosocial development as well as brain morphology and physiology in males with 47, XYY karyotypes is reviewed. RESULTS: Both boys had presentations typical of PDDs, one with autistic disorder and the other with PDD not otherwise specified. CONCLUSION: The finding that, in a clinic for children with developmental disorders, 2 of 40 male referrals had 47, XYY karyotypes suggests that the rate of this sex chromosome anomaly may be increased in PDDs. An extra Y chromosome may be related to abnormal brain development, which may, in turn, predispose vulnerable males to PDDs.

Adolescent↗
PubMed1994

Adaptive function of depression: psychotherapeutic implications.

Using the frameworks of attachment and social hierarchy theories, strategies seen in depression and in normal life are better understood. A hierarchial encounter elicits the "Involuntary Subordinate Strategy" ("ISS") in the loser, which terminates the "ISS" and brings the encounter to an end. These are psychophysiological mechanisms deeply rooted in our phylogenetic ancestry. Loss of a love object also elicits ineffective anger or rage which may, in turn, trigger the ISS. A prolonged intense ISS manifests in depression. Factors are examined that prevent "acceptance" of losing, thereby contributing to an escalation of the ISS and culminating in depressive illness. Psychotherapeutic implications include cognitive restructuring to enable the patient to explore options that might turn off the ISS such as "acceptance" (without making negative self-evaluations), changing unrealistic ideals and aspirations, leaving the scene, or becoming more self-assertive. Case examples are given to illustrate these interventions.

Adult↗
PubMed1994

The social competition hypothesis of depression.

Depressive personality and depressive illness are examined from an evolutionary adaptationist standpoint. It is postulated that the depressive state evolved in relation to social competition, as an unconscious, involuntary losing strategy, enabling the individual to accept defeat in ritual agonistic encounters and to accommodate to what would otherwise be unacceptably low social rank.

Cognitive Behavioral Therapy↗
PubMed1993

Disordered communication and grieving in deaf member families.

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems--a further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.

Adolescent↗
PubMed1991

Use of medication in pervasive developmental disorders.

Medication does not cure PDD, and its use is generally not indicated. However, neuroleptics like haloperidol or trifluoperazine can be useful in the management of behavioral problems. The most common adverse reaction to their use is extrapyramidal effects. However, if one increases the dose gradually and keeps the total daily dose low, the incidence of extrapyramidal effects is likely to remain quite low. A number of drugs that have been used with PDD children and their effectiveness are reviewed. Guidelines for selecting and using an optimal medication for a given patient are also presented. The need to exercise caution in the use of chemicals with severely dysfunctional children, the etiology of whose pathology continues to remain elusive, is stressed.

Antipsychotic Agents↗
PubMed1990

Why families of children with biological deficits require a systems approach.

A number of assumptions related to the systemic therapists' view of family functioning in the case of biological deficit in the child are presented and challenged. The families' behavior, it is argued, may not be primarily responsible for the difficulties of their biologically impaired offspring. Severity of handicap need not be directly linked to stress in these families, nor is avoiding an individual diagnosis helpful to them. To further clarify the relevant issues, the family's "reactions" to a dysfunctional member, along with the professionals' previously unhelpful approaches to dealing with the impairment of these children, are presented. Finally, the therapeutic implications of the position presented in this article are drawn, and specific recommendations for working with these families are offered.

Adaptation, Psychological↗
PubMed1989

Biology of family systems and mood disorders.

Ethology offers psychiatry and family therapy an alternative perspective for understanding hierarchical dysfunction and individual psychopathology and the relation between them. Dominance and submission behaviors--descriptions from ethology--represent communicational mechanisms that play pivotal roles in maintaining the stability of the family group. When conflict becomes acute, dominant and submissive states are experienced as euphoria and mild depression respectively. Smooth functioning of these communicational mechanisms at the individual level enhances cohesion at the group level. Feelings of inadequacy and inferiority may be manifestations of submissive patterns and may function to maintain negative or corrective feedback loops, which preserve group stability. However, these communicational mechanisms may exhibit positive feedback runaway effects such that family crises result. These and other clinical implications of the model are explored.

Affective Disorders, Psychotic↗
PubMed1987

Mood, depressive illness and gait patterns.

This study measures the ground force patterns of 87 normal, older adults. It tests the hypothesis that there is a relation between a subject's mood as measured by the Beck Inventory, and the ground reaction forces as measured by a force plate during normal gait. Results showed that the push-off force in the posterior and downward directions was correlated with the expression of mood state. Lower mood individuals demonstrated a smaller push-off force and these ground force patterns of low mood state subjects resembled the patterns found in a previous study of clinically depressed patients. It is suggested that gait measurement could provide a sensitive index of level of depression in a clinical population.

Aged↗
PubMed1987

Strategic family therapy interventions with deaf member families.

A deviance based model of deafness is compared with one based on ethnicity. The function of inadequate communication in deaf member families is explored. Techniques of intervention are examined with a focus on three strategic interventions namely: 1) circular interviewing; 2) positive connotation; and, 3) use of rituals. Case histories are provided.

Adolescent↗
PubMed1985

Issues in the therapy of hearing children with deaf parents.

The psychiatric literature on deaf children is sparse. Even less attention has been paid to the more common situation of the hearing child raised by deaf parents. Such a child is deprived of the parents' hearing and often the parents' speech. The oldest hearing child in the family often takes on the role of family interpreter which may be a source of both pride and resentment. This can contribute to role reversal leading to a frustration of the child's dependency needs and bitter sibling rivalry. Other problems may result from the parents' ambivalence towards their child. The available literature is surveyed and case illustrations are provided. Suggestions to therapists working with similar families are made.

Adolescent↗
PubMed1983

Inclusive fitness, altruism and family adaptation.

An integrative model of family functioning is put forward using a sociobiological framework. Three key sociobiological concepts that have a relevance to family interaction are inclusive fitness, altruism, and a struggle for status. The term 'inclusive fitness' encompasses the parents' own fitness and that of their kith and kin. Altruism refers to how parents promote the survival of their progeny and extended family. The struggle for status refers to a struggle for power and prestige. According to the author's hypothesis 'inclusive fitness' exerts its influence through the struggle for status which in turn influences the degree of altruism and the level of 'family adaptation'. The parents' level of inclusive fitness largely determines the level of family adaptation which in turn influences the growth and individuation of the next generation. A common negative outcome of failure in the struggle for status and power is a displacement of the struggle for power into a family context. Failure in a struggle for status between peer group members would in a pretechnological society probably have reflected a relative lack of fitness. Failure in the struggle for status is likely to generate maladaptive cycles in the family which will lower the inclusive fitness of the parents. A concept of ideal family functioning is derived from sociobiology and specifically related to a high inclusive fitness in the parents. The author argues that sociobiological concepts can contribute to the development of an integrative theory of family behaviour. The clinical implications of this model are explored.

Adaptation, Psychological↗
PubMed1982

Gait patterns of depressed patients and normal subjects.

The authors compared the gait patterns of 15 patients with affective disorders with those of 15 normal control subjects. The procedure involved a frame-by-frame analysis of a film of each subject walking at normal speed. Angle measurements were made of the hip and knee at their maximum extension during a single gait cycle (one stride). The results generally support the hypothesis that depressed patients walk with a lifting motion of the leg, whereas normal control subjects propel themselves forward.

Adolescent↗
PubMed1981

Responses to methylphenidate and varied doses of caffeine in children with attention deficit disorder.

Six children with the diagnosis of Attention Deficit Disorder were treated as day hospital patients, using different stimulant medication. They were studied in a double-blind crossover experiment in which they received caffeine in low dose or in a high dose. Methylphenidate was added to both dosages, as well as administered alone. Results indicated that caffeine in low dosage when added to methylphenidate was superior to all other treatment conditions. Caffeine in low dosage could not be differentiated from 10 mg of methylphenidate. High dosage caffeine was not different from placebo or no-drug conditions. This study offers evidence to support a curvilinear pattern of dose-response for caffeine, in attenuating the behavioural manifestations of this syndrome.

Attention Deficit Disorder with Hyperactivity↗