Therapy and chronicity.
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Voluntary lid closing inability has been observed in two patients with right-sided frontal ischemic damage. The patients developed a transient inability to close their eyelids voluntarily at the same time as a transient forced grasping in the left hand and left hemiparesis not affecting the face. Automatic and reflex lid closures were retained as well as the ability to keep the eyes closed and to reopen them readily on command. In previous reports, inability to close eyelids voluntarily has been attributed to apraxia, paralysis, or motor impersistence. The localization of the lesion observed in our patients suggests other pathogenetic hypotheses similar to compulsive gaze [19]. It is conceivable that the voluntary lid closing inability produced by frontal lobe lesions is due to the release of a compulsion to maintain the lids elevated in the waking state, because of the overactive effect of the visual stimuli.
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This study investigated the effects of methylphenidate (MPH) on inhibitory control in hyperactive children. A double-blind, placebo-control, within-subject (crossover) design was used in which 12 children, between 6 and 11 years of age, were each tested four times in each drug condition: 0.3 mg/kg and 1.0 mg/kg of methylphenidate, and placebo. Dependent measures included (a) the probability of inhibiting responses to a primary choice reaction time task given a stop signal, on the Stopping Task, and (b) response latency and errors on the Matching Familiar Figures Test (MFFT). MPH improved the efficiency of the central inhibitory mechanism by speeding the inhibitory process, thereby affording the children greater control over their actions and enabling them to increase the probability with which they inhibited responses given a stop signal. MPH increased response latency but did not reduce errors on the MFFT, and observation of the children's task performance highlighted the interpretive problems associated with this task. Performance on both tasks was better at a dosage of 1.0 mg/kg than at 0.3 mg/kg.
Personality test data from the California Psychological Inventory were collected on 99 pairs of identical and 99 pairs of fraternal adult male twins. Heritabilities were comuted for all 18 scales and compared to the heritabilities for "pure" scales with overlapping items omitted. Two of the pure scales, Responsibility and Femininity, had zero heritabilities, whereas all of the full scales had moderate to high heritabilities. It was concluded that item overlap has contributed significantly to previous failures to find evidence for the differential heritability of personality traits as measured by the CPI. CPI items were classified into genetic or environmental categories and separate factor analyses of items in these categories revealed more differences than similarities in factor structure. The genetic personality factors included Conversational Poise, Compulsiveness, and Social Ease. Environmental factors included Confidence in Leadership, Impulse Control, Philosophical Attitudes, Intellectual Interest, and Exhibitionism. Compared to the genetic factors, each of the environmental factors accounted for only a very small percentage of the variance.
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To conclude, (1) although homosexuality has been recognized for hundreds of years, we still do not understand it completely. (2) This paper places emphasis on the process of individuation and gender-identity that takes place very early in childhood as the cause of homosexuality. (3) If the process is not completed properly, the individual's gender-identity will deviate from that of the vast majority of people. Homosexuality is, therefore, considered by me as a deviation from, rather than a variation of, human sexuality. (4) The degree of neurosis or psychosis associated with homosexuality or heterosexuality is not causal in nature, although the two are intimately intertwined. (5) The stress of coming out varies a great deal in intensity and depends on the degree of integration of the individual and the support given to him by his friends, associates, and family. (6) Although the last decade has brought about a greater acceptance of homosexuality than ever before, sufficient prejudice, ignorance, and fear remain to keep many homosexuals "in the closet." (7) Even today the disclosure of one's homosexuality threatens the individual with the loss of so many important aspects of his life, such as his job, his friends, and even his family, that there is little wonder that coming out of the closet poses such problems for so many homosexuals.
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Syncopes due to compulsive respiratory stereotypies were studied in eight patients with autistic features. Most had been referred for episodes thought to be intractable epileptic seizures. Polygraphic recording showed two types of syncope, one induced by prolonged apnea and the other by a prolonged Valsalva maneuver. Fenfluramine, 1.5-3 mg/kg per day, was given in an open trial. In four of five cases with frequent Valsalva maneuvers, respiratory stereotypies and syncopes were suppressed for 2-18 months. Patients with periodic apneas were more severely retarded and had less clear benefit. Side effects consisted of dose-dependent sedation and mild weight loss which stabilized without interrupting treatment. We suggest that these syncopes are volitional and may be associated with pleasant sensations. A double-blind placebo-controlled trial of fenfluramine seems warranted in such patients.
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