Why child neuropsychiatry?]

The author gives a brief survey of the development of Child-Neuropsychiatry in the G.D.R. and subsequently gives reasons for the decision in favor of the unity of neurology and psychiatry as applied to children and juveniles, which is in contrast to developments in other countries. In addition to hygienic, economic, organizational, and medical considerations, this decision was also determined by the fact that a Child-Neuropsychiatrist must, in his practical work as a subspecialist, be able to head a multiprofessional team and, thus, help assure optimum development of a child's personality.     

Letter familiarity does not aid feature extraction

Summary Familiarity effects in visual letter processing were examined by means of a mutilation detection task. The uppercase E was used as the non-mutilated letter. One or two horizontal bars of the E were delected, to produce an upright or inverted F or L. These four mutilations of the E were assigned to the same response. In Experiment 1, brief exposure of the stimuli was followed by a backward mask. Experiment 2 was identical to Experiment 1, except that the display duration of the stimulus was increased and the backward mask was omitted. In Experiment 3, the overall luminance of the stimuli (luminance per point times length of the constituent line segments) was held constant. In Experiment 4, the upright and inverted non-E letter occurred in different blocks to encourage a normal (upright) letter processing strategy in the upright letter blocks. Accuracy (Experiment 1) and mean correct response times (all experiments) were not different for the upright and inverted F or for the upright and inverted L. These findings and converging results from other studies indicate that the higher familiarity of the upright letters did not aid feature extraction.     

The treatment of epilepsies with Convulsofin

The testing of Convulsofin carried out in 220 patients at 14 clinics over a period of six months confirms the international experience gained with valproic acid and sodium valproinate. The main field of application of Convulsofin according to the experience gained will again be the treatment of fits in generalised primary epilepsy for which it permits to carry out a monotherapy to a remarkable extent. The favourable effect of the preparation in photosensitivity could be confirmed. Also in generalised secondary epilepsy and in fits of partial epilepsy. Convulsofin is partly effective, so that it can recommended as a co-medication in the treatment of therapy-resistant forms of these epilepsies which are difficult to treat. Decrease in thrombocytes, transient increase in serum transaminases, gastrointestinal disorders, loss of hair and undesired increases in body-weight were the more frequently occurring side-effects.     

Disintegrated experience: the dissociative disorders revisited

We present proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and review the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of two new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. We conclude that further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.     

Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population

This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study

In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.     

Dichotic listening during forced-attention in a patient with left hemispherectomy

A young left-handed girl with an extensive posttraumatic lesion in the left hemisphere was tested with dichotic listening (DL) under three different attentional instructions. The major aim of the study was to evaluate a structural vs attentional explanation for dichotic listening. As both her expressive and receptive language functions were intact after the lesion, it was assumed that the right hemisphere was the language-dominant one. In the free-report condition, she was free to divert attention to and to report from both ear inputs. In the forced-right condition, she was instructed to attend to and report only from the right ear input. In the forced-left condition, she was instructed to attend to and to report only from the left-ear input. Her performance was compared with data from a previously collected sample of normal left-handed females. Analysis showed that the patient, in contrast to the normal sample, revealed a complete right-ear extinction phenomenon, irrespective of attentional instruction. Furthermore, she showed superior correct reports from the left ear, compared with those of the normal sample, also irrespective of attentional instruction. It is concluded that these results support a structural, rather than attentional explanation for the right-ear advantage (REA) typically observed in dichotic listening. The utility of validating the dichotic listening technique on patients with brain lesions is discussed.