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PubMed1993

Paranoia: a part of most analyses.

Paranoid defenses appear during most analyses, sometimes with great intensity, but often subtly, and require specific analytic attention. Preoedipal conflicts, inner fears around passivity, narcissistic injury and rage, and subsequent masochistic and projective defenses lie at the core of these patients' pathology. In addition, specific cognitive, object-relational, and affective distortions reflecting multiple developmental levels emerge during analysis. A case vignette is provided to demonstrate the analysis of a neurotic patient without borderline features who showed prominent paranoid formation.

Adult↗

PubMed1997

What is consciousness?

In the past few years scientists and scholars in a variety of disciplines have been making concerted efforts to answer an ancient question, namely, How exactly do the physical processes in the brain cause consciousness? What is distinctive about the way in which modern scientists and scholars are approaching this question is that they are treating it as a scientific problem rather than a metaphysical one. This transition reflects the air of expectation in contemporary cognitive science to the effect that an empirical solution is imminent to a philosophical problem that previously was considered insoluble. Nevertheless, a recent authoritative review of the publications of such leading contemporary workers in the field as Francis Crick, Daniel Dennett, Gerald Edelman, Roger Penrose, and Israel Rosenfield has concluded that they have all failed to provide a satisfactory answer to the question (Searle 1995a). The present paper makes a psychoanalytic contribution to this interdisciplinary effort and provides an alternative answer to the question, based on Freud's conceptualization of the problem of consciousness. The paper takes a concrete example from Searle's review, reanalyses it within Freud's metapsychological frame of reference, and shows how this frame provides a radical solution to the problem. This implication of Freud's work has not hitherto been recognized and so has not received the attention it deserves.

Awareness↗

PubMed1998

Abnormal frequency mismatch negativity in mentally retarded children and in children with developmental dysphasia.

The auditory event-related potential waveform termed "mismatch negativity" was examined in 12 mentally retarded children with delayed development of speech and language (aged 5-8 years) and in 13 children with developmental dysphasia (aged 5-9 years). The mismatch negativity waves were elicited with pure sine-wave tone stimuli using the oddball paradigm. We measured the peak latency and peak amplitude of mismatch negativity responses to frequency (500/553 Hz) difference. The mismatch negativity patterns were compared with those of 10 children with normal development of linguistic skills (aged 5-9 years). In both the mentally retarded and dysphasic groups, the peak amplitude of the frequency mismatch negativity was significantly attenuated when compared with the control group, but no significant difference was observed between the mentally retarded and dysphasic groups. Attenuated frequency mismatch negativity was related to impairment of linguistic skills irrespective of the child's cognitive skills. Because the mismatch negativity response reflects central auditory processing and is modal specific for auditory stimuli, this change-specific response can serve as an objective tool to elucidate central auditory deficits in children.

Aphasia↗

PubMed1997

P300 from men with a family history of alcoholism under different incentive conditions.

OBJECTIVE: Males with a family history of alcoholism (Family History Positive [FHP]) have frequently been reported to show an attenuated amplitude of the P300 component of the EEG event-related potential (ERP). The purpose of the present study was to explore the influence of incentives on the amplitude of the P300 to Target stimuli in FHP and FHN (Family History Negative) men. METHOD: The ERPs of 20 FHP and 20 FHN men were recorded in a visual discrimination task under two conditions: a no incentive (Neutral) and a reward/loss of reward (Incentive) conditions. ERPs following Target, Non-Target and Novel stimuli were examined. RESULTS: The FHP subjects displayed the expected attenuation of P300 amplitude, regardless of the stimulus type (Target, Non-Target or Novel), compared to the FHN subjects. The FHN subjects showed the predicted effect of a significantly increased P300 amplitude following Target stimuli in the Incentive condition whereas the FHP subjects did not display significantly greater P300 amplitudes in response to the incentive. CONCLUSIONS: These results may reflect a deficit in the motivational-cognitive system of FHP subjects. Analyses suggest that changes in P300 amplitude in response to the incentive can be predicted by subjects' scores on self-report measures of sensation seeking and behavioral undercontrol. However, such measures could not explain subjects' absolute P300 amplitude to Target stimuli.

Adult↗

PubMed1997

Visual discrimination in adult dairy bulls.

Adult Holstein-Friesian dairy bulls were trained to recognize a black disk and then to discriminate between that disk and smaller ones. The bulls learned these tasks, but much more slowly than did dairy calves. Achievement of a consistently high percentage of correct choices varied among bulls because of daily variation in the disposition of the bull, which seemed to affect willingness to concentrate on the experimental task. Nevertheless, all bulls demonstrated learning, and each bull remembered very well what he once had learned. A 36-cm disk was easily detected and discriminated from smaller disks. However, bulls were not able to discriminate between two disks that differed in area by less than a factor of 4. The ability to use visual cues, such as shapes and size of shapes, suggested that the visual system is important in the biology of bulls. The slow learning rate and the variability in the percentages of correct responses were not considered to be an indication of cognitive disabilities in general but rather a reflection of the daily disposition of the bull, which affected his willingness to cooperate.

Animals↗

PubMed2000

Predictive factors of post-discharge mortality in the hospitalised elderly.

AIM: To study the death rate of noninstitutionalised elderly after discharge from hospital, describe the causes of death and identify predictive factors of mortality. METHODS: Vital status and cause of death of patients was ascertained by linkage to the death registry I year post discharge. Age, sex, race, marital status, housing and class of ward (to reflect socioeconomic status), presence of carer, Elderly Cognitive Assessment Questionnaire (ECAQ) score, Barthel score, presence of depression, number of chronic illnesses and length of stay in the hospital were studied as potential predictive factors for mortality using Cox proportional hazard regression models. RESULTS: Death occurred in 38 out of 113 patients. The commonest causes of death were malignancy (18%) and cerebrovascular disease (18%). Barthel score and length of stay were independent significant predictive factors of mortality. Elderly with low ECAQ score, with carers and from C class wards also had higher mortality although these results were not statistically significant. CONCLUSION: Post-discharge mortality is high in the elderly. We recommend that further studies be done to determine if amelioration of these predictive factors would lead to decreased mortality or improvement of quality of life.

Aged↗

PubMed2004

[Concept analysis and critical thinking: a complementary relationship in nursing].

The purpose of this paper is to demonstrate the relationship between the concept analysis process and critical thinking skills in nursing. Utilizing a discursive essay approach, it is argued that the concept analysis technique enhances critical thinking. The steps of the concept analysis are analyzed as to the inherent cognitive operations that represent critical reasoning processes. Reflecting on an experience with undergraduate nursing students, the technique of concept analysis is evaluated as a didactic activity that enhances critical thinking. It is concluded that both processes complement each other in the rethinking of nursing and in confronting challenging practice situations.

Education, Nursing↗

PubMed1979

The relationship of personality style to abstract thinking deficits in schizophrenia.

Hypothesized that the correlation between Inability to Abstract and Autism measures of schizophrenics would be larger after the effects of relevant personality variables were partialed out than before. The multiple correlations of these deficit measures with 15 of the Sixteen Personality Factor scales and a measure of verbosity were determined in a sample of 100 schizophrenics. The correlations between Inability to Abstract and Autism before and after those scales that contributed significantly to the Rs had been partialed out also were calculated. Neither was significant. The results offer no support for the view that observed differences between schizophrenic subgroups in inability to abstract and autism reflect variations in personality style rather than cognitive factors.

Adult↗

PubMed1978

[New methods in the objective audiometry for the proof of simulation and for the determination of the differential thresholds for frequency and intensity (author's transl)].

The "late acoustically evoked potentials" (50 to 300 msec) can be recorded in different stages of vigilance and awareness; therefore their significance as a correlate of conscious central perception is doubtful. The "very late DC-potentials" (300 msec and more) reflect conscious central perception because of their cognitively determinated features and can be used for the proof of simulation. Their application in ERA comprises the determination of the hearing threshold, the "objective speech audiometry" and the determination of the differential thresholds. The "objective frequency decrement test" gives additional informations about the degree and the specifity of a hearing loss. The objective proof of the differential threshold for intensity demonstrates the insufficient significance of the SISI test.

Audiometry↗

PubMedDate not supplied

Prenatally drug-exposed children in out-of-home care: are we looking at the whole picture?

Publicity on children exposed prenatally to drugs has fostered tremendous concern about their cognitive and behavioral development. This concern is reflected in the out-of-home care system, where the number of children from drug-involved families has increased dramatically. This article examines the conflicting views in the literature on the effects of prenatal exposure to drugs and reports on an early intervention project in a New York City agency. The rate of developmental delay was found to be virtually the same for children with and without prenatal exposure to drugs. Implications of these findings for practice and research are considered.

Child, Preschool↗

PubMed2005

Symptoms of depression in older home-care patients: patient and informant reports.

The purpose of this study was to examine the level of agreement and patterns of disagreement between home-care patient and informant reports of depressive symptoms. The authors interviewed a sample of 355 older home-care patients and their informants using the Structured Diagnostic Interview for DSM-IV (R. L. Spitzer, M. Gibbon, & J. B. Williams, 1995). Informants reported more psychological symptoms than patients, and this type of discrepancy was higher for patients with cognitive impairment and patients who had younger informants. Younger informants also reported more cognitive symptoms, whereas patients were more likely to report suicidal thoughts or ideation if they were not cognitively impaired. The patterns of these discrepancies may reflect age- and cohort-related response bias in the reports of depressive symptoms obtained from older adults.

Adult↗

PubMed1997

Help clients develop hopes for the future.

The purposes of this article are (a) to examine cognitive, emotional, and spiritual aspects of hope as reflected in the literature; (b) to describe three clinical approaches that have been used in occupational therapy to engage clients in development of hopes for the future; and (c) to consider practical issues that have been raised by therapists seeking to incorporate development of hopes in their practice. Literature from health care and the social sciences indicates that cognitive, emotional, and spiritual aspects of hope are interwoven in a complex process that evolves over time after major loss. Three alternative clinical strategies for collaborating with clients in developing hopes are reviewed, including a goal-setting and goal-attainment approach, an occupational change approach, and a life history approach. These clinical strategies are illustrated by the stories of an elderly mental health client, an adult rehabilitation client, and an adolescent orthopedic client, which are drawn from research in which the authors have been involved. Discussion of issues involved in incorporating hope work into daily practice is based on the experiences of practicing therapists who participated in a workshop. These include pragmatic issues of documentation and reimbursement of this aspect of practice as well as clinical issues of how to develop hopes among clients who appear hopeless.

Adolescent↗

PubMed1990

Spatial cognition in Parkinson disease.

Visuospatial deficits have been found repeatedly in patients with Parkinson disease (PD). However, their precise nature and significance remain controversial. Whereas it is often asserted that primary visuospatial impairments begin early in the disease, others argue that poor performance on visuospatial tasks reflects methodological artifact. This article reviews research on spatial cognition in PD. Five categories of spatial functions are described: visual analysis and synthesis; facial recognition; judgment of direction, orientation, and distance; constructional praxis; and spatial attention. Proposed guidelines for future research include the use of conceptual rather than operational definitions of visual spatial ability, greater attention directed at separating spatial from nonspatial task components, and studies examining basic mechanisms underlying spatial vision.

Aged↗

PubMed1997

Event-related desynchronization in the alpha band and the processing of semantic information.

The hypothesis was tested whether event-related power shifts in the upper alpha band are specifically related to semantic memory processes. In Expt. 1 subjects had to judge whether pairs of sequentially presented words (W1-W2) were semantically congruent. In the following experiments subjects were presented the W1 words of Expt. 1 and were asked to perform a free association task in Expt. 2 and a cued recall task in Expt. 3. It is assumed that semantic memory demands dominate in Expt. 1, whereas working memory demands dominate in Expt. 3 and that Expt. 2 takes an intermediate position with respect to both types of task demands. A significant task-related power change that responds selectively to semantic processing demands was found for the upper alpha band and over the left side of the scalp. The lower alpha band, on the other hand, most likely reflects unspecific processing demands such as attention. A more general interpretation of these findings is that different cognitive processes such as semantic memory, perceptual encoding and attentional processes are reflected by band power changes in different and rather narrow frequency bands over localized regions in the brain.

Adult↗

PubMed2006

Children, adolescents, and the internet: a new field of inquiry in developmental psychology.

With this special section on children, adolescents, and the Internet, we survey the state of a new field of inquiry in developmental psychology. This field is important because developmentalists need to understand how children and adolescents live in a new, massive, and complex virtual universe, even as they carry on their lives in the real world. We have selected six empirical articles to showcase various aspects of child and adolescent development in this virtual universe. These articles reflect three major themes of this new field: communication on the Internet; cognitive development, academic achievement, and the Internet; and adolescents in a globalized Internet world. These three sections reflect one of our major editorial goals: to sample various relevant aspects of development as they relate to the Internet. The selection of articles reflects a second editorial goal: to sample both the positive and negative aspects of the virtual world in which children and adolescents are increasingly living. Another of our editorial goals was to sample as large an age range as possible. We also utilized a very broad definition of development. Last but not least, we sought out and found methodological diversity.

Adolescent↗

PubMed2002

Effects of haemoglobin and serum ferritin on cognitive function in school children.

The association between iron deficiency anaemia and cognitive function impairment has been widely reported in young children, but whether the impairment is a result of iron deficiency per se or a combination of iron deficiency and anaemia, and how these conditions interact, is still questionable. Four hundred and twenty-seven school children from two schools in socioeconomically deprived communities were selected in southern Thailand. Iron status was determined by haemoglobin and serum ferritin concentrations. Cognitive function in this study was measured by IQ test and school performance, including Thai language and mathematics scores, using z-scores based on distributions within the same grade and school. Data on demography and socioeconomic status were collected by questionnaire answered by the parents. Linear regression models were used to investigate the effect of anaemia and iron deficiency, reflected by haemoglobin and serum ferritin concentration, on cognitive function and school performance. We found that cognitive function increased with increased haemoglobin concentration in children with iron deficiency, but did not change with haemoglobin concentration in children with normal serum ferritin level. Children with iron deficiency anaemia had consistently the poorest cognitive function (IQ, 74.6 points; Thai language score, 0.3 SD below average; and mathematics score, 0.5 SD below average). Children with non-anaemic iron deficiency but with high haemoglobin levels had significantly high cognitive function (IQ, 86.5 points; Thai language score, 0.8 SD above average; and mathematics score, 1.1 SD above average). This study found a dose-response relationship between haemoglobin and cognitive function in children with iron deficiency, whereas no similar evidence was found in iron sufficient children.

Anemia↗

PubMed2000

Axis II psychopathology in individuals with traumatic brain injury.

PRIMARY OBJECTIVES: To determine the frequency and nature of post-TBI personality disorders (PDs) in a community-based sample of individuals with TBI. RESEARCH DESIGN: One hundred individuals with TBI were administered a structural clinical interview to determine Axis II psychopathology. METHODS OF PROCEDURES: The Structured Clinical Interview for DSM-IV Personality Disorders, Clinician Version (SCID II) was used to determine 12 Axis II personality disorders. SCID II questions were modified so that symptom onset could be rated as occurring pre-injury vs. post-TBI. Data were analysed using student T-tests, chi-square analysis and one way analyses of variance. OUTCOMES AND RESULTS: Pre-TBI PDs were diagnosed in 24% of the sample; antisocial PD and obsessive-compulsive PD were the most common diagnoses. Post-TBI, 66% of the sample met criteria for at least one PD, with PDs independent of TBI severity, age at injury, and time since injury. The most common post-TBI PDs were: borderline, avoidant, paranoid, obsessive-compulsive and narcissistic. Men were more likely to be diagnosed with antisocial PD and narcissistic PD. Individuals with pre-TBI PDs were at greater risk of acquiring additional psychopathology post-TBI. Personality traits endorsed by more than 30% of the sample post-TBI reflected loss of self-confidence, attempts to cope with cognitive and interpersonal failures and negative affect. CONCLUSION: These findings argue against a specific TBI personality syndrome, but rather a diversity of personality disorders reflective of the persistent challenges and compensatory coping strategies developed by individuals post-TBI. Prospective need for clinical assessment, pro-active education and focused treatment approaches are discussed.

Adaptation, Psychological↗

PubMed1995

Cognitive functioning and magnetic resonance imaging in chronic fatigue.

BACKGROUND: This study examines whether cognitive dysfunction in chronic fatigue may be accounted for by depression and anxiety or is due to brain pathology evident on magnetic resonance imaging (MRI). METHOD: Twenty-six subjects with chronic fatigue, with and without coexisting depression, and 18 age-matched normal controls were recruited from primary care following a presumed viral illness six months previously. Comparison was made with 13 psychiatric controls with depressive illness on standardised cognitive tests. MRI determined the presence of cerebral white-matter lesions. RESULTS: No substantial differences in performance were shown between subjects with chronic fatigue, most of whom met the criteria for chronic fatigue syndrome, and controls. Subjective cognitive dysfunction increased with psychopathology. White-matter lesions were found in a minority from all groups. Improvement in fatigue and depression coincided with improved performance on cognitive measures. CONCLUSIONS: Subjective complaints of cognitive impairment are a prominent feature of chronic fatigue, but objective cognitive and MRI abnormalities are not. Such complaints probably reflect psychopathology rather than a post-viral process.

Adolescent↗