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PubMed1968

[Introduction to the problems of the symposium on moderate encephalopathies in young children].

Two reasons have decided of the choice of the thema: The intention to stressing the clinical aspect of the psychiatry of children and the frequency of the encephalopathy under different form. These problems have become a social calamity and demand urgently social prevention, therapy and rehabilitation. The priority of psychoanalysis in certain countries causes the underestimation of the organic basis which, since, at very beginning of individual life contributes to change the reactivity of the individual. A great number of psychic disorders traditionally considered as psychogenic might have a source in minimal, subclinical alterations of the brain tissue caused by various etiological factors. From a biological point of view the individual biography does not start in the moment of birth but at conception. The secret of psychic health is hidden in the genetic elements of life. All the aspects of individual development have their value in regard to modern psychiatric diagnosis. In spite of the immense progress in the diagnostic skill, it is difficult to discover the remote causes. We can only approach to an ideal using the clinical methods: PEG, EEG, arteriography and others. Thanks to these examinations oligophreny, epilepsy and other diseases are no more nosological units but symptomatological or syndromological notions with various etiology and localisation. Different authors suppose different localisation of alterations causing erethism. A part of the brain may be damaged but the principle of the brain synergy as a whole is obligatory. Our researches have contributed to liquidate almost entirely the ancient conception of psychopathy. Our material enabled us to classify character disorders into 4 categories: Constitutionally conditioned psychopaths, sociopaths, homilopaths whose character disorders are the consequence of contact difficulties with their environment because of their infirmity, Characteropaths which represent character disturbances caused by organic brain defects. The diagnostic criteria are not psychopathologic but somato-clinical. The psychopaths' quantity decreases in dependence of exactitude of our methods. The morbid reactivity of characteropathic children exposes them to secondary neurotisation and sociopathisation. Our traditional opinions concerning hysteria and obsessive neurosis should undergo radical supervision: severe cases have a basis in a organic brain damage. These examples throw light on the etioepigenesis phenomena, i.e. on the stratification of functional psychotic or neurotic syndromes on a psychoorganic substratum.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed2005

Acquired sociopathy and frontotemporal dementia.

BACKGROUND: It is not understood why some patients with frontotemporal dementia (FTD) manifest sociopathic behavior. OBJECTIVE: To examine the prevalence and characteristics of sociopathic behavior in FTD patients as compared to those with Alzheimer's disease (AD). METHODS AND PARTICIPANTS: We surveyed a group of FTD patients and a group of AD patients for sociopathic behavior, evaluated the characteristics surrounding their acts, and compared the groups on neuropsychological tests and functional neuroimaging. Twenty-eight outpatients with FTD (15 men, 13 women; 61.9+/-7.1 years; Mini-Mental State Examination score 23.6+/-8.1) were compared with 28 patients with clinically probable AD (13 men, 15 women; 66.1+/-9.2 years; Mini-Mental State Examination score 21.3 +/- 5.3). Main outcome measures included: (a) the prevalence of sociopathic acts; (b) a structured interview; (c) neuropsychological tests including the Frontal Assessment Battery, and (d) clinically obtained positron emission tomography or single photon emission tomography scans. RESULTS: Sixteen (57%) of the FTD patients had sociopathic behavior compared to two (7%) of the AD patients (chi(2)=13.84, p<0.001). Sociopathic acts among FTD patients included unsolicited sexual acts, traffic violations, physical assaults, and other unacceptable behaviors. On interview, the FTD patients with sociopathic acts were aware of their behavior and knew that it was wrong but could not prevent themselves from acting impulsively. They claimed subsequent remorse, but they did not act on it or show concern for the consequences. Among FTD patients with sociopathy, neuropsychological assessment showed impaired motor inhibition, and functional neuroimaging showed right frontotemporal involvement. CONCLUSION: The results suggest that sociopathy in FTD results from a combination of diminished emotional concern for the consequences of their acts and disinhibition consequent to right frontotemporal dysfunction. In many jurisdictions, FTD patients with sociopathy would not pass legal criteria for 'not guilty by reason of insanity'.

Aged↗

PubMed1976

Experiment in managing sociopathic behaviour disorders.

A ward catering for both sexes admitted patients with aggressive suicidal, or otherwise disturbed behaviour for observation and treatment until decisions could be made about their long-term needs. Patients were referred from the police, special hospitals, and the courts and some were transferred from other wards in the hospital. A third of the first 100 patients were admitted for forensic reasons. Twelve inmates were discharged to long-term accommodation for disturbed patients. The ward was intended to provide fairly short-term accommodation, though no time limits were set, and it was run as a medium secure unit. The ward was run by 16-18 nurses with support from medical teams, occupational therapists, and clinical psychologists. It has secured its status as a special unit within the hospital and will continue with the active support of the hospital staff.

Adolescent↗

PubMed1978

Utilization of the Goldberg MMPI profile classification rules for the assessment of psychopathology in different clinical populations.

MMPI profiles of 545 psychiatric inpatients and 560 incarcerated offenders were separated sequentially into normal, sociopathic, neurotic and psychotic groups by means of Goldberg's profile classification rules. Patient-prisoner differences in both rates of classification and profile patterns of groups within diagnostic categories were assessed quantitatively, and profiles were interpreted by use of standard MMPI codebooks. For the hospitalized Ss comparisons also were made between clinical diagnoses and Goldberg-MMPI classifications. The resulting differences in classification rates, similarities of profiles within diagnostic categories, correspondence between obtained and codebook-expected profiles, and agreement between clinical and Goldberg-MMPI classifications were not such that this approach could be used with confidence as a basis for establishing diagnostic group membership. Although Goldberg's system appears to represent certain improvements over previous criterion-related methods of profile classification, it was concluded that its value nonetheless is limited by the assumption of an invariant relationship between test patterns and nontest variables.

Adult↗

PubMed1987

Violent crime, sociopathy and love deprivation among adolescent delinquents.

Ever since Wechsler observed that the adolescent sociopath characteristically scored higher on the performance section of the Wechsler IQ scale relative to the verbal section, psychologists have been debating its meaning. This study examines the relationships between P-V discrepancy scores, love deprivation, and juvenile delinquency among a sample of juvenile probationers. P greater than V scores were significantly related to love deprivation and violent crimes. It was determined that much of the explanatory power of P greater than V with regard to violent delinquent behavior was mediated by love deprivation. We also found that P greater than V scores could not be explained away by social class, low verbal scores, or lower full-scale scores. Only love deprivation was found to be significantly related to P greater than V scores in our path model, thus offering some support to the assertions of some authors that early emotional stresses affect subsequent autonomic nervous system function.

Adolescent↗

PubMed1976

The WISC as a diagnostic tool.

Wechsler's hypotheses for the adolescent sociopath were applied to the WISC under controlled conditions. Groups were separated according to race and sex, while IQ, socioeconomic class, and geographic location were held constant. The criterion for selection of Ss was appearance before a juvenile court. The efficiency of each of Wechsler's signs was determined. Post hoc analysis provided specific signs for each combination of race and sex in the 80-89 IQ range. The need for cross-validation of these signs was stressed. Other methodological issues that may contribute to inconclusive findings with traditional assessment procedures were discussed throughout the study. These included: (1) the need for control of the relevant variables; (2) the problem of poorly defined criteria; (3) the need for analysis of the individual as well as the group data; (4) the importance of a holistic approach; (5) the problem with matching; and (6) the problem of not having an expected distribution with which to compare the frequency of "hits" for Wechsler's indices.

Achievement↗

PubMed1999

Tests of executive functioning predict scores on the MacAndrew Alcoholism Scale.

1. Previous work reported that tests of executive functioning (EF) predict the risk of alcoholism in subject populations selected for a "high density" of a family history of alcoholism and/or the presence of sociopathic traits. The current experiment examined the ability of EF tests to predict the risk of alcoholism, as measured by the MacAndrew Alcoholism Scale (MAC), in outpatient subjects referred to a general neuropsychological testing service. 2. Sixty-eight male and female subjects referred for neuropsychological testing were assessed for their past drinking histories and administered the Wisconsin Card Sorting Test, the Wechsler Adult Intelligence Scale-Revised, the Trails (Part B) Test, and the MAC. Principal Components analysis (PCA) reduced the number of EF tests to two measures, including one that loaded on the WCST, and one that loaded on the Similarities, Picture Arrangement, and Trails tests. Multiple hierarchical regression first removed the variance from demographic variables, alcohol consumption, and verbal (i.e., Vocabulary) and non-verbal (i.e., Block Design) IQ, and then entered the executive functioning factors into the prediction of the MAC. 3. Seventy-six percent of the subjects were classified as either light, infrequent, or non-drinkers on the Quantity-Frequency-Variability scale. The factor derived from the WCST on PCA significantly added to the prediction of risk on the MAC (p = .0063), as did scores on Block Design (p = .033). Relatively more impaired scores on the WCST factor and Block Design were predictive of higher scores on the MAC. The other factors were not associated with MAC scores. 4. These results support the hypothesis that decrements in EF are associated with risk factors for alcoholism, even in populations where the density of alcoholic behaviors are not unusually high. When taken in conjunction with other findings, these results implicate EF test scores, and prefrontal brain functioning, in the neurobiology of the risk for alcoholism.

Adult↗