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[Ethology and research in infantile autism].
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Psychological correlates of compliance.
A urinary assay (17 kgs/creatinine) was used to measure compliance in 31 acute lymphocytic leukemia patients under 15 years of age receiving oral prednisone. Demographic data and psychological test responses of patients and their parents were correlated with the urinary assays. Results indicated that while the rate of compliance was the same for boys and girls, the psychological correlates were very different. Parental personality traits and attitudes were more involved with boy's compliance than with girl's. Some of the parent variables associated with compliance in boys were hostility, anxiety, and obsessive-compulsive behavior. Parents described compliant boys as vulnerable. These traits usually are considered maladaptive but in this case appear to facilitate boy's compliance. For girls, far fewer parent variables were associated with compliance. Parents seemed to have less worry and concern about their daughters and presumably give them the responsibility for their own medication. It was the girl's own anxiety which predicted compliance.
[Mini-inventory of anankastic personality traits].
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Behavioral mechanisms and loci of drug dependence: an overview.
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[Influences of health resort rehabilitation and psychotherapy on the self-concept of patients (author's transl)].
Which effects of rehabilitative/preventive treatment and psychotherapy during health resort rehabilitation procedures can be demonstrated in self-concept of patients? Are the effects of preventive/rehabilitative treatment sufficient to stabilise psychologically impaired patients? Both at the beginning and at the end of health resort rehabilitation, 123 non-selected patients without psychotherapy, and 76 psychologically impaired patients who had received an average 7.5 hours of psychotherapeutic care, answered the Giessen test. Significant differences in initial and retest values are interpreted as effects of the rehabilitative/preventive treatment, and as combined treatment plus psychotherapy effects. In order to obtain those effects that are attributable solely to psychotherapy, 29 persons showing equivalent values had been selected from each of the main sample populations, and comprised in two parallel samples. 1. Reduced depressiveness and an increase in positive social responsiveness are interpretable as effects of the treatment, with initial values having however been relatively inconspicious. 2. Psychotherapy patients are more compulsive, considerably more depressive, as well as more withdrawn and reduced in social potential than the other patients. The combined effect of treatment and psychotherapy achieved a marked decrease in depressiveness and compulsive behaviour, with positive social responsiveness and social potential increasing. 3. These same effects are present in the control group, and therefore are shown to be attributable to psychotherapy, not to the rehabilitative/preventive treatment received. If the psychologically impaired patients are left without psychotherapeutic care, depressiveness and compulsive behavior will on the whole persist. They continue to feel rejected and despised, and remain unable to use the social opportunities available during health resort rehabilitation procedures. Their social potential does not increase.
Onset of menses in two adult patients with Prader-Willi syndrome treated with fluoxetine.
Prader-Willi syndrome (PWS) is characterized by hypotonia at birth, hypogonadism, early childhood obesity, and mental deficiency. Hypogonadotropic hypogonadism is a major characteristic of patients with PWS, and it is speculated to be due to hypothalamic insufficiency. Two adult female patients with PWS and no prior history of menses are presented. Both of these patients were treated with fluoxetine for psychopharmacologic management of obsessive features in the form of food preoccupation and hyperphagia or for compulsive behaviors in the form of severe self-injurious behaviors. The two female patients with PWS who had primary amenorrhea developed vaginal bleeding believed to be menses following at least 6 months of treatment with fluoxetine. Mature hypothalamic function is characterized by pulsatile release of gonadotropin-releasing hormone (GnRH) in a critical range of frequency and amplitude. Central nervous system neurotransmitters may modify GnRH secretion. Fluoxetine specifically inhibits the reuptake of serotonin which may impact the hypothalamic-pituitary-ovarian system in female patients with PWS.
[From tics to the Gilles de la Tourette syndrome].
We report a case whose progressive course and forms of manifestation of generalized tic movements indicate relatively rare Gilles de la Tourette disease. It is characterized by the triad--non-coordinated mobility-dyskinesia, echolalia corporalia, epilepsy and according to the current data from the literature, compulsive behavior, phobias and sometimes episodes of insanity in the advanced stage. The clinical case we report as well as cases from the world literature is rather dubious, asks for prolonged follow-up and has polymorphic symptomatology and necessitates a multidisciplinary therapeutic approach. Beside the clinical features, laboratory findings has also been discussed.
Tourette syndrome associated with mental retardation: a single-subject treatment study with haloperidol.
A Tic Checklist and direct observation tic measurement procedure were developed for the assessment of Tourette syndrome in individuals with mental retardation. Using a single-subject reversal design, we applied this assessment method to the evaluation of haloperidol treatment for a subject with Tourette syndrome and severe mental retardation. Relative to baseline, haloperidol 10 mg/day produced decreases of 66% in simple motor tics, 46% in complex motor tics, 45% in simple vocal tics, and 50% in complex vocal tics. Improvement was also seen in careprovider ratings of tic severity, hyperactivity, and compulsive behaviors.
Quantitative trait loci involved in genetic predisposition to acute alcohol withdrawal in mice.
Alcohol dependence (alcoholism) is accompanied by evidence of tolerance, withdrawal (physiological dependence), or compulsive behavior related to alcohol use. Studies of strain and individual differences using animal models for acute physiological dependence liability are useful means to identify potential genetic determinants of liability in humans. Behavioral and quantitative trait analyses were conducted using animal models for high risk versus resistance to acute physiological dependence. Using a two-step genetic mapping strategy, loci on mouse chromosomes 1, 4, and 11 were mapped that contain genes that influence alcohol withdrawal severity. In the aggregate, these three risk markers accounted for 68% of the genetic variability in alcohol withdrawal. Candidate genes in proximity to the chromosome 11 locus include genes encoding the alpha1, alpha6, and gamma2 subunits of type-A receptors for the inhibitory neurotransmitter, GABA. In addition, suggestive linkage is indicated for two loci on mouse chromosome 2, one near Gad1 encoding glutamic acid decarboxylase, and the other near the El2 locus which influences the seizure phenotype in the neurological mutant strain El. The present analyses detect and map some of the loci that increase risk to develop physiological dependence and may facilitate identification of genes related to the development of alcoholism. Syntenic conservation between human and mouse chromosomes suggests that human homologs of genes that increase risk for physiological dependence may localize to 1q21-q32, 2q24-q37/11p13, 9p21-p23/1p32-p22.1, and 5q32-q35.
[Personal destiny: determination, will, and action].
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Effect of nicotine on quinpirole-induced checking behavior in rats: implications for obsessive-compulsive disorder.
BACKGROUND: Rats treated chronically in a large, open field with the dopamine D2/D3 receptor agonist quinpirole (QNP) develop compulsive checking behavior as defined by a set of behavioral criteria. This paradigm has been suggested as an animal model of obsessive-compulsive disorder (OCD). Because nicotine blocks various behaviors induced by ontogenetic QNP administration, we asked whether nicotine could attenuate QNP-induced compulsive checking. METHODS: Adult male Long-Evans rats (n = 14/group) were treated twice weekly with saline (control), or with QNP (0.5 mg/kg) for 14-16 injections. On the last two injections, rats were pretreated in random order with an acute dose of nicotine (0.3 mg/kg base) or saline 10 min before administration of QNP or saline; and the effects on checking behavior was examined. The effects of chronic QNP treatment on nicotinic receptors in discrete brain regions were also determined. RESULTS: Chronic QNP resulted in compulsive checking and increases in cerebellar alpha4beta2 and alpha7 nicotinic receptor densities. Nicotine pretreatment significantly reduced one of the three measures of compulsive checking behavior. CONCLUSIONS: Nicotine attenuates some symptoms of compulsive checking in a rat model of OCD; however, the mechanisms of this effect and therapeutic efficacy of nicotinic agonists in OCD require further study.
[Obsessive-compulsive disorders--inpatient behavior therapy].
Exposure therapy with response prevention is regarded as the most effective treatment in obsessive compulsive disorder. This procedure has been applied in outpatients as well as inpatients.
Case study: behavioral treatment of obsessive-compulsive disorder in a boy with comorbid disruptive behavior problems.
Comorbid psychiatric conditions often complicate the treatment of childhood obsessive-compulsive disorder (OCD). Behavioral treatment of OCD using exposure plus response prevention for a boy with disruptive behavior disorders and two previous unsuccessful medication trials is described. Treatment was adapted to his developmental level, his mother was highly involved in treatment, and a contingency management program contained his disruptive behavior so that he could participate in therapy. Posttreatment and 2- and 6-month follow-up measures indicated marked improvement in OCD symptoms. The possibility of successful behavioral treatment of OCD in medication-free children with disruptive behavior problems is highlighted.
Sexual misconduct by health care providers.
1. Just as in society in general, health care providers can engage in compulsive sexual behaviors that jeopardize their health, careers, and relationships, both personal and professional. 2. Sex addicts not only deny and rationalize their acts but also resist accepting any feedback about their sexually inappropriate behaviors. 3. To protect patients from sexual misconduct, health care providers who exhibit sexually inappropriate behaviors must be confronted, and consistent limits must be set, including terminating patient contact, if necessary. 4. Treatment for sexually compulsive behaviors is multifaceted, and signs that a person is cooperating with treatment are ceasing the compulsive behaviors, experiencing feelings of remorse, expressing regret, accepting personal responsibility, and abiding by guidelines for reinstatement.
Invited case transcript. Obsessive-compulsive disorder: a behavioral case formulation.
The interviewing skills of many behavior therapists are inadequate and several possible reasons are discussed. The present manuscript focuses on construction of initial clinical hypotheses. A strategy for developing and testing initial hypotheses is presented and illustrated by transcripts from a complex case. The transcript is taken from the initial interviews with a 26 year old woman presenting the problems of emotional distress related to thoughts of harming others, and anxiety concerning her difficulty in controlling physical aggression. A behavioral analysis of the origins and maintaining factors indicated that while the patient's compulsions were a vehicle to manage anxiety, the wellspring of her attempts to exert control over her thoughts was a fear of anger, loss of control, negative evaluation, criticism, and rejection. Distal and proximal predisposing events were examined in order to help explain the development of this maladaptive behavioral pattern, and to plan therapeutic strategy.
On pregenital compulsive phenomena and the repetition compulsion.
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Compulsive buying and risky behavior among adolescents.
Using a scale designed to measure compulsive buying of adolescents, a survey was conducted to assess the relationships of compulsive buying with several risky behaviors among 111 adolescents between the ages of 12 to 19 years. The correlations suggest that self-report measures of cigarette smoking, alcohol use, drug use, and likelihood of engaging in premarital sex were all significantly associated (rs = .30 to .32) with compulsive buying among teenagers. Implications of the results are discussed, and directions for research are offered.