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Biomedical subjects

N E Alessi

Publications and source records attributed to N E Alessi.

At least 19 recordsLinked to original sources
PubMed2001

Digital motion phenomenology of depression.

The long-term objective of our project is to use motion capture technology to identify and characterize body alterations in motion associated with depression that have not been previously recognized or characterizable. These motion phenomena will be studied to determine their utility in the nosology and subtyping of depression. Quantitatively, they may have a significant impact in the areas of research, education and the clinical management of depression; and allow the creation of "virtual humans" which manifest depressive digital motion phenomena that can be used to train researchers, trainees and clinicians.

Depressive Disorder↗
PubMed1999

Presence as an emotional experience.

Presence or the sense of "being there" has been discussed in the literature as an essential, defining aspect of Virtual Reality (VR). The VR literature includes definitions rooted in behavioral response, signal detection theory, and philosophy, but has generally ignored the emotional aspects of experience. The purpose of this paper is to reexamine the concept of presence in terms of people's emotional engagement with reality and their environment. Emotions are an essential part of how people experience the world. Any theory of presence must take emotional factors into account. This thesis has implications about how research should be conducted to further our understanding of presence. Validated psychological techniques for assessing emotions by subjective report, behavioral observations, and facial analysis can all be applied to increase our understanding of virtual presence. Further understanding of the interaction between presence and emotional state will improve our understanding of the construct of presence as well as better inform us about how virtual environments can be applied in creating emotional effects or treating emotional disorders.

Emotions↗
PubMed1999

The use of an information system architecture modeling tool in the development of disease management systems.

UNLABELLED: A Disease Management System (DMS) refers to an integrated healthcare delivery system that provides patient centered care throughout the course of the disease independent of delivery site. A fundamental barrier for the development, implementation and monitoring of a DMS is lack of an appreciation by care providers of the complexity of these systems, and what is required for their maintenance. Foremost in the development of these systems is the presence of information systems that attempt to deal with the temporal, spatial and information needs of the DMS. PURPOSE: The Zachman Framework for Information Systems Architecture is used in many industries in the development of information systems. Its choice is based on the recognition of a need for a methodology in the conceptualization and modeling of complex information systems. This paper provides a brief overview of the Zachman Framework and its potential application in DMS development. In particular it will be the focus on the need for "perspective" clarification as the first step in the development of such complex systems. RESULTS: This paper reviews DMS and their potential information needs. The clarification of "perspectives" provides a method toward team building and unification of purpose by decreasing conflict and recognizing the unique contributions that each perspective holder makes.

Delivery of Health Care, Integrated↗
PubMed1998

Comparing virtual and real worlds for acrophobia treatment.

Traditional treatment of phobias involves a process of gradual exposure to the feared object. Virtual Reality (VR) environments have been used to effectively treat phobias by simulating feared situations, yet these initial studies have been performed by comparing the effect to no-treatment conditions. We are in the process of comparing VR exposure treatment to "gold-standard" in-vivo exposure treatment by replicating an actual in-vivo exposure area in a VR model. The process of controlling for differences between the two environments highlights a general procedure of selecting elements in virtual environment design, targeted towards producing particular emotional effects. It also raises questions about the necessity for highly realistic simulation in VR phobia treatment.

Behavior Therapy↗
PubMed1998

The potential relevance of attachment theory in assessing relatedness with virtual humans.

Primary efforts to create virtual humans have been in the production of computer generated ergonomically correct objects that look like humans. Although there has been concern with essential human factors, absent are the metrics of human relatedness, or the ability to assess the degree to which a virtual human elicits human emotions. We discuss the potential application of attachment theory as a context for the development of such an assessment paradigm, and specifically the application of the Ainsworth Strange Situation in the evaluation of a "Virtual Mom". Virtual relatedness fidelity is discussed as a macrometric to define relatedness that would occur with virtual humans. Potential lessons learned are discussed as they apply to the selection of those to develop the model, and its impact on the introduction of virtual humans into clinical psychiatry and psychology.

Adult↗
PubMed1998

Current limitations into the application of virtual reality to mental health research.

Virtual Reality (VR) environments have significant potential as a tool in mental health research, but are limited by technical factors and by mental health research factors. Technical difficulties include cost and complexity of virtual environment creation. Mental health research difficulties include current inadequacy of standards to specify needed details for virtual environment design. Technical difficulties are disappearing with technological advances, but the mental health research difficulties will take a concerted effort to overcome. Some of this effort will need to be directed at the formation of collaborative projects and standards for how such collaborations should proceed.

Computer Simulation↗
PubMed1996

The Internet and the future of psychiatry.

OBJECTIVE: The Internet is a rapidly growing communications resource that is beginning to have an impact on medicine, and it is anticipated that the Internet will soon have a major effect on psychiatry. It is essential for psychiatrists to have a conceptual framework for understanding the many aspects of the Internet. METHOD: Using a four-layer model, the authors describe the components of the Internet and how these work together to establish communication. They discuss some of the practical implications of the model, potential future applications of the Internet, and some of the challenges its use will create. RESULTS: In the Internet model described, the bottom three layers involve hardware and modes of information transmission; the fourth layer is human interaction. The Internet has great potential in psychiatric education, clinical care, research, and administration, but major adjustments in individual and organizational expectations and responses will be needed. These changes relate to the speed, dispersion, volume, privacy, and permanence of communication. CONCLUSIONS: The growth of the Internet and related information technologies is inevitable and has diverse technical and social implications. As psychiatrists, we must remain effective communicators of information and adjust to a changing world with new roles and skills that will permit us to best serve our professional mission.

Computer Communication Networks↗
PubMed1994

Effects of depression on memory performance and metamemory in children.

OBJECTIVE: To investigate the effects of depression on memory performance and metamemory in children. METHOD: Performance on automatic memory tasks (frequency of occurrence), effortful memory tasks (Children's Auditory Verbal Learning Test), and a Metamemory Battery were examined in 21 unmedicated, depressed children and 21 nondepressed controls (matched for age, gender, and full-scale IQ). Subjects were divided into three groups based on depression severity (high depressed, low depressed, nondepressed). RESULTS: High depressed patients demonstrated performance deficits relative to nondepressed and low depressed children on the Children's Auditory Verbal Learning Test, Immediate Recall trial. Both groups of depressed children performed more poorly on the Metamemory Battery when compared to nondepressed children. Severity of depression differentiated overall performance. Metamemory performance of depressed subjects indicates possible difficulty with overestimation of memory abilities. No differences were found on automatic memory task performance. CONCLUSIONS: Memory impairment in depression varies as a function of severity and may be evident only when a certain level of depression is reached. Overestimation of memory ability by depressed children may be an attempt to compensate for feelings of inadequacy or inferiority. It may also lead depressives to use poor judgment in selecting appropriate solutions for problems. Targeting these cognitive distortions could be a focal point of clinical and educational interventions.

Attention↗
PubMed1992

Utility of an oral diffusion sink (ODS) device for quantification of saliva corticosteroids in human subjects.

Measurement of cortisol by assay of single blood or saliva samples is inherently imprecise due to the episodic secretion of cortisol. In addition, assay of blood usually quantifies total cortisol, rather than separating free hormone, which is proportionately the much smaller fraction. Furthermore, the free fraction may be disproportionately higher in hypercortisolism. Urinary free cortisol is one measure that provides both a time integral and a focus on the free fraction, but it is inconvenient and prone to collection error in unsupervised ambulatory subjects. The Oral Diffusion Sink (ODS) apparatus takes up corticosteroids from saliva according to first-order kinetics and may provide a practical alternative. We assessed the utility of the ODS in a study of seven healthy volunteers admitted to the CRC for three days. Data on day two from 0700-1100 h and 1100-1500 h were compared between the ODS and three other means of assessing cortisol: urinary free cortisol (UFC), blood, and saliva. The subjects all tolerated wearing the ODS device without any complaint. High correlations were observed between ODS values vs. data for UFC, plasma, and saliva determinations. In summary, the ODS device was well tolerated and collected reliable corticosteroid data, and thus provides a new, non-invasive methodology for studies of HPA function in health and disease.

Adrenal Cortex Hormones↗
PubMed1992

Acute and chronic administration of trazodone in the treatment of disruptive behavior disorders in children.

We report the results of an open trial of trazodone in the treatment of severe behavioral disturbances in a sample of 22 hospitalized children previously found to be unresponsive to other treatments. Response to treatment was assessed by overall clinical criteria and improvements in individual symptom dimensions during the inpatient hospitalization. Thirteen children (67%) were found to benefit from the introduction of trazodone. Aggressive, impulsive behaviors were symptoms most frequently improved by this agent. Three of those found to be nonresponders actually worsened in symptomatology. A follow-up interview of the parents was conducted 3-14 months after discharge from the inpatient unit, for those children who initially responded to trazodone administration. The results of this interview suggest that the effect of trazodone was persistent for a prolonged period of time after the initial inpatient trial. Trazodone appears to be of value in the management of severe behavioral disturbances in children. The possible mechanism of action of trazodone is discussed.

Aggression↗
PubMed1991

Characterization of beta-endorphin-related peptides in the caudal medulla oblongata and hypothalamus of the prenatal, postnatal and adult rat.

A comparison was made of beta-endorphin (B-END) concentrations versus post-translation products during the perinatal period in the hypothalamus and the caudal medulla oblongata. The concentration of B-END-like immunoreactivity did not differ statistically between embryonic day 21 (E21) and postnatal day 1 (P1) in either area. There were significant differences in forms, with a shift from larger precursors at E21 to smaller peptides at P1, with the predominant form of B-END being the 31 residue form at E21 in both regions. B-END varied between the two regions at P1, the 27-26 residue predominant in the hypothalamus, and the 31 residue in the caudal medulla.

Aging↗
PubMed1990

Plasma dexamethasone levels in children given the dexamethasone suppression test.

To determine whether children who demonstrate dexamethasone suppression test (DST) nonsuppression have lower plasma dexamethasone levels than DST suppressors, we administered the DST to 73 patients ranging in age from 5-14 years. Plasma dexamethasone levels and postdexamethasone cortisol levels were measured at 4:00 PM on day 2. We found: (1) DST nonsuppressors had significantly lower plasma dexamethasone levels (p less than 0.03) than suppressors; similar trends were observed when the population was divided into depressed and nondepressed patients; (2) mg/m2 dose of dexamethasone was directly correlated with plasma dexamethasone (p less than 0.003) and inversely correlated with postdexamethasone plasma cortisol levels (p less than 0.04); and (3) a statistically significant inverse correlation between plasma dexamethasone levels and postdexamethasone cortisol levels (p less than 0.04). Our findings show that plasma dexamethasone levels are important in evaluating DST results in psychiatrically disturbed children and suggest that dexamethasone dosage for use in the DST in children might be better calculated in terms of body surface area.

Adolescent↗
PubMed1990

Formulating a role for occupational therapy in child psychiatry: a clinical application.

Occupational therapy is in need of role clarification within the specialty of child psychiatry. The literature reveals that occupational therapy is often undelineated or unrecognized by child psychiatry, has limited efficacy research, and may be at risk for losing its practice with children hospitalized for psychiatric disturbances. This paper outlines steps for the formulation of a specialized role for occupational therapy within this specialty. The Model of Human Occupation (Kielhofner, 1985) is suggested as a basis for conceptualizing this role. A clinical study focused on the evaluation of adaptive functioning with use of the Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984, 1985) is presented as an example of a way in which occupational therapy can provide assessment data valuable to the interdisciplinary clinical team. The role of occupational therapy in both short-term and long-term hospitalization of children with psychiatric disturbances is described.

Adaptation, Psychological↗
PubMed1989

Prepubertal anorexia nervosa and major depressive disorder.

A case of a 9-year-old girl with anorexia nervosa and a major depressive disorder is reported. The age of onset brings into focus the relationship between depressive disorders, weight loss, and anorexia nervosa in children. The increasing incidence of childhood dieting and the implications of the prepubertal onset for hypotheses of the etiology of anorexia nervosa are discussed.

Anorexia Nervosa↗
PubMed1989

Pseudoarylsulfatase A deficiency in a psychiatrically disturbed adolescent.

A case of pseudoarylsulfatase A deficiency in an adolescent boy presenting with affective lability, impulsivity, aggression, inattention, and academic difficulties is described. Genetically related to metachromatic leukodystrophy, pseudoarylsulfatase A deficiency has generally been felt to be a benign disorder. Pseudodeficiency of arylsulfatase A has, however, been associated with serious psychiatric morbidity in recent studies. Possible explanations for this association are suggested. To the best of the authors' knowledge, this is the first case report of pseudoarylsulfatase A deficiency in a psychiatrically disturbed adolescent.

Adolescent↗