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Population studies of polymorphisms at loci of neuropsychiatric interest (tryptophan hydroxylase (TPH), dopamine transporter protein (SLC6A3), D3 dopamine receptor (DRD3), apolipoprotein E (APOE), mu opioid receptor (OPRM1), and ciliary neurotrophic factor (CNTF)).

We determined allele frequencies for polymorphisms at several loci of interest in neuropsychiatry-tryptophan hydroxylase (TPH), dopamine transporter protein (SLC6A3), D3 dopamine receptor (DRD3), apolipoprotein E (APOE), ciliary neurotrophic factor (CNTF), and the mu opioid receptor (OPRM1)-in samples of individuals from populations in several different parts of the world. Associations with psychiatric illness have been proposed for specific polymorphisms at TPH (suicide-related behaviors and impulsivity), DRD3 (schizophrenia and bipolar affective disorder), SLC6A3 (susceptibility to cocaine-induced paranoia and attention-deficit disorder), CNTF (psychosis), and OPRM1 (substance dependence). APOE alleles are related to risk of Alzheimer disease. We found significant allele frequency variation among populations at all six loci. These results will provide a global framework of normal variation at these loci that might have functional significance or otherwise be related to susceptibility to various disorders or behavioral phenomena. Knowledge of this variation can be important for study design and data interpretation when individuals from various population groups are research subjects and may eventually help lead to a better understanding of behavioral adaptation.

Alleles↗

Emotion in the criminal psychopath: fear image processing.

We tested the hypothesis that the response mobilization that normally accompanies imagery of emotional situations is deficient in psychopaths. Cardiac, electrodermal, and facial muscle responses of 54 prisoners, assigned to low- and high-psychopathy groups using R. D. Hare's (1991) Psychopathy Checklist--Revised, were recorded while subjects imagined fearful and neutral scenes in a cued sentence-processing task. Groups did not differ on self-ratings of fearfulness, imagery ability, or imagery experience. Low-psychopathy subjects showed larger physiological reactions during fearful imagery than high-psychopathy subjects. Extreme scores on the antisocial behavior factor of psychopathy predicted imagery response deficits. Results are consistent with the idea that semantic and emotional processes are dissociated in psychopaths.

Acoustic Stimulation↗

The flesinoxan 5-HT1A receptor challenge in major depression and suicidal behavior.

The prevailing neurochemical theory about biological correlates of suicidal behavior focuses on the serotonergic system. In this study, we assessed the cortisol, ACTH, GH, prolactin and temperature responses to flesinoxan, a5-HT1A agonist, in 30 DSM-III-R major depressed inpatients subgrouped into suicide attempters (n = 15) and nonattempters (n = 15). The patients were assessed after a drug-free period of at least 3 weeks. A subsample of 16 patients completed the Buss-Durkee Hostility Inventory as a measure of impulsive aggressive behavior. Mean delta cortisol responses to flesinoxan were significantly lower in the group of depressed patients with a history of suicide attempts than in the group without history of suicidal behavior: for the delta cortisol values 14.5 +/- 16.3 micrograms/l vs 101 +/- 94 micrograms/l (F = 8.9, df = 5.25, p = 0.006). There was also a very significant difference between suicide attempters and nonattempters for the temperature (delta T degrees) responses to flesinoxan: 0.20 +/- 0.24 degrees C vs. 0.60 +/- 0.24 degrees C (F = 18.1, df = 5.25, p = 0.0003). Hormonal and temperature responses to flesinoxan were not correlated with BDHI irritability or assault subscale scores. The results of the present study support the implication of the serotonergic system, particularly 5-HT1A receptors, in the control of self-directed aggressive behavior. Moreover, in depressed patients, serotonergic abnormalities do not appear to be related to aggressive behavior.

Adult↗

Behavioral and physiological characteristics of Indian and Chinese-Indian hybrid rhesus macaque infants.

Strain differences in temperament and physiology have been reported for several animal species, but nonhuman primates have not been well studied in this regard. We assessed behavioral and physiology in Chinese-Indian hybrid (n = 13) and Indian-origin (n = 29) nursery-reared rhesus monkey infants. Previous data indicate that Chinese-origin and Chinese-Indian hybrid rhesus exhibit more aggression directed toward humans and conspecifics and are more irritable in response to neonatal assessment procedures than are Indian-derived rhesus. In addition, in rhesus adults, low levels of cerebrospinal fluid 5-HIAA have been correlated with impulsivity, aggressive behavior, and diminished social competence. We therefore hypothesized that hybrid infants would exhibit more behavioral and adrenocortical reactivity in the home cage and during social separations, would be less sociable in their peer groups, and would exhibit lower CSF 5-HIAA levels than Indian-derived monkeys. Blood and cerebrospinal fluid samples were obtained on Days, 14, 30, 60, 90, 120, and 150 of life, and prior to and during social separations at 6 months of age. Behavioral observations were conducted in the home cage and during the separation condition. No differences in behavior were observed between hybrid and Indian-derived animals in the home cage. Indian-derived and hybrid infants exhibited diverging patterns of behavioral reactivity across the 4 weeks of the repetitive social-separation procedure, and during reunion periods. Although plasma cortisol levels were sensitive to the testing conditions, no group differences were observed. CSF 5-HIAA declined over time for all monkeys, and hybrid animals exhibited significantly lower 5-HIAA levels than Indian monkeys beginning at 6 months of age. These findings are consistent with the known behavioral and physiological characteristics of Chinese-origin adult rhesus.

Analysis of Variance↗

Multi-impulsivity among women with bulimia nervosa.

OBJECTIVE: The results of past research suggest the possible existence of a distinct subgroup of bulimic individuals who display multiple behaviors indicative of impulsivity (e.g., stealing, self-injury, attempted suicide, drug abuse). We further investigated potential relationships between multi-impulsivity and other clinical variables. METHOD: We compared women with bulimia nervosa (purging type) who displayed "multi-impulsivity" (n = 40) to those who did not (n = 177) with regard to symptom history and presentation, eating-disordered attitudes, and sexual experience. RESULTS: The two groups did not differ in mean age, body mass index, scores on scales of eating-disordered attitudes and traits, incidence of self-induced vomiting, sexual intercourse, or masturbation, and current frequency of binge eating and self-induced vomiting. However, relative to the comparison group, women in the multi-impulsive group reported earlier onset of binge eating and sexual intercourse, a greater incidence of laxative abuse, and use of a greater number of different substances. There were statistical trends (p < .10) toward the multi-impulsive group displaying earlier onset of self-induced vomiting, laxative abuse, and masturbation. DISCUSSION: Results are discussed in relation to the results of past research and the implications for treatment of bulimic women.

Adult↗

Frontal reactivity and sensation seeking an ERP study in skydivers.

1. In the line of Zuckerman's studies on sensation seeking and optimal level of arousal, the authors hypothesized that high sensation seeking might be used to compensate for anhedonia due to basal arousal deficit. A population of interest was found with parachutists practicing skydiving, generally described as very high sensation seekers. 2. After clinical assessment of emotional and affective components, amplitudes of the frontal P3 of the ERP were used as indices of arousal. 3. Skydivers presented more negative symptoms (anhedonia and blunted-affect) than controls. This was observed in isolation from any depressive episode, which would suggest the presence of emotional deficit as a trait. As expected, skydivers presented more sensation seeking than controls. These two results taken together could indicate that sensation seeking is an adaptive reaction to anhedonia. 4. ERP results showed that frontal P3 amplitudes were larger in skydivers than in controls, whereas in a previous study we showed the opposite in depressed patients with a similar emotional deficit. This could indicate that the frontal P3 amplitude does not reflect the emotional deficit per se. We suggest that it rather reflects the capacity to use some behaviors which improve automatic attentional processes in order to obtain arousing stimulation that could counterbalance the emotional deficit. Depressions with emotional deficit might be due to the lack of such a capacity.

Adult↗

[Utilization behavior during the course of progressive multifocal leukoencephalopathy].

A particular semiologic feature of a case of progressive multifocal leukoencephalopathy was the existence of utilization behavior as described by Lhermitte. The affection developed in a patient with myeloid leukemia treated by cytotoxic drugs. Multifocal low density areas were shown by CT Scan examination. The course of the disease was not altered by isoprinozine therapy.

Adult↗

Effects of fluoxetine on aggressive behavior of adult inpatients with mental retardation and epilepsy.

Nineteen mentally retarded inpatients with epilepsy and a history of current or recent aggressive behavior were treated with 20 mg of fluoxetine daily. All were concurrently taking other psychotropic medications, including carbamazepine and neuroleptics. A standardized rating scale (MOAS) was used to assess the effects of fluoxetine on aggressive behavior. There were wide individual differences in drug response. In nine patients, fluoxetine treatment was associated with increased aggression, while drug withdrawal led to a decrease to below pretreatment levels. Two hypotheses concerning the apparent association between fluoxetine and increased aggression are discussed: 1) adverse effects secondary to either drug interaction or fluoxetine overmedication; and 2) a specific serotonergically mediated effect on the regulation of aggression. This study suggests that the clinician who treats mentally retarded patients with impulsive aggressive behavior should remain aware that fluoxetine may have diverse effects on aggression that vary over time and interindividually.

Adult↗

Ego-delay and vocational behavior.

Two hypotheses derived from ego analytic vocational theory were tested using neuropsychiatric patients referred for vocational rehabilitation procedures. Subjects who obtained higher ego-delay scores derived from a time estimation technique were found to obtain higher vocational aptitude scores and higher levels of vocational readjustment following disability. Issues for counseling and further research are discussed.

Adult↗

Anorexia nervosa "restricters" who purge: implications for subtyping anorexia nervosa.

It has not been clear from earlier studies whether it is binge eating per se or the compensatory behaviors frequently associated with binge eating (i.e., self-induced vomiting and/or laxative abuse) that provide the most relevant marker for subclassifying anorexia nervosa. The current study addressed this question by comparing the clinical and psychological features of three groups of anorexia nervosa patients: "pure restricting" patients who do not binge (by definition) and who also do not purge (AN-R, N = 116); "restricting-purging" patients who engage in purging behavior (AN-RP, N = 74); and anorexia nervosa "bulimics" who binge eat as defined in earlier studies (AN-B, N = 190). While all three groups displayed similar levels of psychological disturbance on many variables, the overall pattern of findings indicates that the AN-RP group displays significantly more psychopathology than the AN-R group and their profile of disturbance is very similar to that observed with the AN-B group. Thus, anorexia nervosa patients who purge, regardless of whether or not they report objective binge episodes, may be meaningfully distinguished from nonpurging patients. These results, combined with the medical risks associated with purging behaviors and the formidable problems associated with the definition of binge eating, support a sub-typing system for anorexia nervosa based on the presence or absence of purging rather than binge eating.

Adult↗

The sexual struggles of 23 clergymen: a follow-up study.

Nineteen clergymen, 17 of whom were Catholic, were followed up 1 to 6 years after their initial evaluation in a program designed to assess the sexual offenses and rehabilitation potential of offending professionals. Methods used included a semistructured interview with a research psychiatrist and a repeat of the MCMI-III. At follow-up, the clergymen were relatively psychologically healthy. The vast majority of the men had returned to previous or higher levels of vocational functioning and felt that they had benefited from their initial evaluation and therapy. None of those who were initially suspected of sexual compulsivity met criteria for excessive sexual expression at follow-up, and none had re-offended. The typical clergyman, whether heterosexual or homosexual, was struggling with loneliness, masturbation conflicts, and the wish to be known beyond their role by others. The confrontative style of the evaluators in pursuing the veracity of the clergy's initial explanations of their behaviors and the use of penile plethysmography were the primary objections to the methods used. Brief psychotherapy seemed to be a cost-effective, well-received intervention for clergy struggling with their sexual conflicts.

Adult↗

Sib group therapy: a prevention program for siblings from drug-addicted families.

To prevent drug abuse among younger siblings of addicted adolescents, weekly group therapy sessions were implemented at a suburban therapeutic drug community. The concept evolved as an outgrowth of family therapy which revealed that intergenerational addictive patterns might impose a high future risk of similar behavior among latency age children. Results after 18 months indicate that although severe group acting-out behavior has diminished, underlying psychodynamics appear somewhat unchanged. Some evidence of experimentation with alcohol has emerged. Conclusions are that superego development is still impoverished but the tenacity of the group's existence provides positive speculations of ultimate success.

Adolescent↗

Measuring inhibitory control in children.

The Stop Signal Task is a measure of inhibitory control in which subjects must press a button in response to a stimulus. On certain trials, the subject receives a second stimulus (the Stop Signal) after the primary stimulus and must withhold his/her response during those trials. The onset of the Stop Signal is varied, sometimes coming immediately after the primary stimulus (inhibition is easy); at other times, the Stop Signal arrives quite late, making inhibition difficult. Results from the Stop Signal Task were obtained from children with attention-deficit/hyperactivity disorder (ADHD) and from controls; children with ADHD had significantly more difficulty inhibiting their responses than did controls. In a second study, results from the Stop Signal Task were obtained from a large sample of both behaviorally disturbed and community children; variables from the Stop Signal Task correlated well with both laboratory observations and teacher ratings of inattention and hyperactivity.

Anxiety Disorders↗

[Suicidal behavior in childhood and early puberty--syndromatic nosologic aspects].

The author points out the necessity to separate suicidal behaviour in childhood and early puberty on the one hand and of adults on the other hand. Suicidal acts (attempted suicides) of 100 suicidants at the age until sixteen are analyzed on syndromatic-nosologic aspects. Preventive-prophylactic measures are shortly mentioned.

Adolescent↗

Genetic correlation between performance on an appetitive-signaled nosepoke task and voluntary ethanol consumption.

The present study used a signaled appetitive nosepoke task as a measure of behavioral control or impulsivity related to reward system function in mice and determined how impulsivity correlated with voluntary ethanol consumption. Thirteen inbred strains were trained to nosepoke for food rewards and eventually trained to nosepoke for reward when an auditory signal was presented. Efficiency in the signaled nosepoke task indicated the ability of the mice to withhold the nosepoke response until the signal to respond for a reward was given and was considered indicative of behavioral control or impulsivity. After completion of the nosepoke task, the mice were tested for ethanol consumption in a three-bottle choice test at 3 and 10% (v/v) ethanol concentrations. Behavioral measures from the nosepoke task and ethanol consumption measures were correlated to determine a genetic relationship. High efficiency, the ability to withhold nosepoking until signaled, was negatively correlated with ethanol consumption. Thus, the strains who were better able to control their behavioral responding (i.e., less impulsive) consumed less ethanol, and strains who were more impulsive consumed more ethanol. This genetic relationship may be a mouse behavioral model for some of the neuropsychological traits demonstrated in human subjects who are family history-positive for alcoholism.

Alcohol Drinking↗

Abnormalities in hair trace elements as indicators of aberrant behavior.

There are long-standing viewpoints that impulsive and violent behavior may stem from brain dysfunction or damage secondary to head injury, disease, or toxic chemical substances. This research has aimed to examine the relationship between potentially toxic metals and aberrant behavior, especially violent activity, through the nonintrusive technique of hair analysis for trace elements. In an initial study, phase I, it was not possible to replicate findings of others who reported high levels of lead, cadmium, and copper in violent offenders. However, high levels of manganese were found in prison versus control groups. In phase II, the possibility of artifactual results arising from prison cooking utensils was controlled for by sampling early after incarceration. Phase III was included to substantiate the initial post hoc findings in an additional jail population. In both latter phases, significantly elevated manganese levels were found in the hair of violent versus nonviolent subjects (P less than .0001). A review of the effects of manganese at deficient and toxic levels does not provide a simple answer as to why manganese levels are elevated in the hair of individuals who have been incarcerated for violent behavior. Our study does not implicate the prison environment or soaps and shampoos used in California prisons. Other factors, such as alcohol, dietary, or psychosocial factors, might influence manganese levels in hair, or any of these factors might function in combination with mild manganese toxicity to contribute to aberrant behavior.

Adult↗

Propranolol treatment of assaultive patients with organic brain disease. A double-blind crossover, placebo-controlled study.

A double-blind, placebo-controlled crossover study was conducted to examine the effects of long-acting propranolol in the treatment of violent behavior associated with organic brain disease in 10 patients whose symptoms had proved refractory to various conventional medications. Long-acting propranolol treatment was associated with reductions of assaultive behavior without apparent sedative effects. Cautions are noted regarding potential undesirable side effects which may necessitate careful patient monitoring during treatment.

Adult↗