Body image in social anxiety disorder,obsessive–compulsive disorder,and panic disorder

Body dysmorphic disorder falls under the category of obsessive–compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive–compulsive disorder (OCD; n = 22), social anxiety disorder (SAD; n = 25), and panic disorder (PD; n = 21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.     

Is seasonal affective disorder a disorder of circadian rhythms?

Seasonal affective disorder (SAD) is a form of depression that starts in the fall and ends in the spring. This article reviews existing theories about the relationship between circadian rhythms and the disorder. Recent research indicates that as with pharmacologic antidepressants, at least 2-4 weeks are needed to demonstrate the effectiveness of bright-light therapy compared to placebo. The response to such treatment is strongest with precisely timed light exposure: treatment is optimal during the morning hours when the circadian system is susceptible to phase advance. Such clinical improvement is correlated with the magnitude of the phase shift induced. These observations suggest a model of circadian function in SAD and provide important guidelines for its treatment.     

Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy?

Little is known about the etiology of histrionic personality disorder (HPD) or its relation to other personality disorders. In this study, we examined whether HPD is etiologically related to psychopathy and more specifically whether HPD and antisocial personality disorder (ASPD) are sex-typed alternative manifestations of psychopathy. In addition, based on Newman's (1987) response modulation hypothesis of psychopathy, we examined the associations between psychopathic, HPD, and ASPD features and performance on laboratory measures of passive avoidance errors and interference effects. Seventy-five live theater actors completed self-report questionnaires and two laboratory measures of response modulation, and peers completed questionnaires concerning the participants' personality disorder features. The results provided weak and inconsistent support for the hypotheses that HPD is a female-typed variant of psychopathy and that ASPD is a male-typed variant of psychopathy. Contrary to previous findings, scores on response modulation tasks were not significantly related to psychopathy, or to either HPD or ASPD. The limitations of this study and possibilities for future research in this area are outlined.     

Does comorbid attention-deficit/hyperactivity disorder impact the clinical expression of pediatric obsessive-compulsive disorder?

What is the impact of attention-deficit/hyperactivity disorder (ADHD) on the phenotypic expression of pediatric obsessive-compulsive disorder (OCD). We examined phenotypic features, and functional and clinical correlates in youths with OCD, with and without comorbid ADHD, from a large sample of consecutively referred pediatric psychiatry patients. Although comorbid ADHD had no meaningful impact on the phenotypic expression or clinical correlates of OCD, it was associated with higher rates of compromised educational functioning compared with other OCD youths. Our findings suggest that the OCD phenotype runs true and is not impacted by comorbid ADHD in youths diagnosed with both OCD and ADHD. In such affected youths, both disorders contribute to morbid dysfunction and require treatment. More work is needed to determine whether OCD plus ADHD represents a developmentally and etiologically distinct form of the OCD syndrome.     

Is ADHD a disinhibitory disorder?

Attention deficit hyperactivity disorder (ADHD) is widely theorized to stem from dysfunctional inhibitory processes. However, the definition of inhibition is imprecisely distinguished across theories. To clarify the evidence for this conception, the author relies on a heuristic distinction between inhibition that is under executive control and inhibition that is under motivational control (anxiety or fear). It is argued that ADHD is unlikely to be due to a motivational inhibitory control deficit, although suggestions are made for additional studies that could overturn that conclusion. Evidence for a deficit in an executive motor inhibition process for the ADHD combined type is more compelling but is not equally strong for all forms of executive inhibitory control. Remaining issues include specificity to ADHD, whether inhibitory problems are primary or secondary in causing ADHD, role of comorbid anxiety and conduct disorder, and functional deficits in the inattentive ADHD subtype.     

Is cluttering a motor disorder?

A 15-year-old-boy was referred on account of a fluency disorder that was not thought to be stuttering. The problems of the lack of an adequate definition of cluttering are discussed along with the inherent problems of providing a wide-based assessment of this client group. Assessments were conducted on the motoric, linguistic, and intellectual abilities of this client, and the findings are discussed.     

Attention deficit hyperactivity disorder (ADHD): An affect‐processing and thought disorder?

In the literature on child and adolescent psychoanalysis attention deficit hyperactivity disorder (ADHD) is described as complex syndrome with wide‐ranging psychodynamic features. Broadly speaking, the disorder is divided into three categories: 1. a disorder in early object relations leading to the development of a maniform defence organization in which object‐loss anxieties and depressed affects are not worked through via symbolization but are organized in a body‐near manner; 2. a triangulation disorder in which the cathexis of the paternal position is not stable; structures providing little support alternate with excessive arousal, affect regulation is restricted; 3. current emotional stress or a traumatic experience. I suggest taking a fresh look at ADHD from a psychoanalytic vantage point. With respect to the phenomenology of the disorder, the conflict–dynamic approach should be supplemented by a perspective regarding deficits in α‐function as constitutive for ADHD. These deficits cause affect‐processing and thought disorders compensated for (though not fully) by the symptomatology. At a secondary level, a vicious circle develops through the mutual reinforcement of defective processing of sense data and affects into potential thought content, on the one hand, and secondary, largely narcissistic defence processes on the other. These considerations have major relevance for the improved understanding of ADHD and for psychoanalytic technique.     

Spastic dysphonia: A fluency disorder?

A case is presented for classifying spastic dysphonia, which usually is classified as a disorder of phonation, as a disorder of fluency—one that has a symptomatology and phenomenology, and possibly etiology, which is similar to stuttering. This case is based in part on a study that is reported in which listeners described speech associated with this condition as lacking in fluency. Theoretical, clinical, and research implications are discussed.     

Auditory agnosia: apperceptive or associative disorder?

Neuropsychological testing of a patient with auditory agnosia showed that certain difficulties in the initial analysis of sounds may be the cause of his inability to understand spoken words and other sounds. Abnormalities included a slow reaction time to brief auditory stimuli (but not to equally brief visual stimuli or to longer auditory stimuli) and the need for approximately 1/4 sec of silence between two tones before the patient was able to hear them as separate. He could identify words and word associations if he was able to view the object whose name or word associate he was hearing. The findings imply that this patient's deficit in comprehending speech was probably apperceptive rather than associative in origin.     

Can Developmental Trauma disorder be distinguished from posttraumatic stress disorder? A confirmatory factor Analytic Test of Four Structural Models

Research on Child and Adolescent Psychopathology - Developmental Trauma Disorder (DTD) is a proposed child psychopathology diagnosis with emotion/somatic, attention/behavioral, and self/relational...     

Is obsessive-compulsive disorder caused by a second-messenger imbalance?

Although the precise etiologic nature of obsessive-compulsive disorder (OCD), one of the most common psychiatric conditions, is unknown, several findings indicate involvement of the serotonin (5-HT) transporter. Apart from the specific effects of selective 5-HT reuptake inhibitors, other studies show decreased functionality of the platelet 5-HT transporter in OCD. In this report, the authors combine data from two independent studies of patients with OCD, showing both an increased activity of protein kinase type C (PKC) and a decreased activity of protein kinase type A (PKA). The authors propose a unifying hypothesis that OCD might be determined by an imbalance between PKC and PKA, with a prevalence of the former and, more generally, of the phosphoinositide over the cyclic adenosine monophosophate (cAMP) pathway. Should this hypothesis prove correct, the path would be open for new therapeutic interventions in the treatment of OCD.     

To do or not to do? Prospective memory versus response inhibition in autism spectrum disorder and attention-deficit/hyperactivity disorder

In the present research, event-based prospective memory and response inhibition (RI) abilities were investigated in children with ASD (Study 1), with ADHD (Study 2), and their matched neurotypical controls. Children engaged in a categorisation (ongoing) task and, concurrently, in either an event-based prospective memory (PM) or a Go/No-Go secondary task. Results showed that, as compared to their matched controls, ASD children's performance was more impaired in the PM task than in the Go/No-Go task, while the performance pattern of ADHD children was reversed. In the ongoing task, ASD children were as accurate as, but significantly slower than, controls, independently of conditions. ADHD children did not differ from controls in the presence of a concurrent PM task, while they were less accurate than controls in the presence of the go/no-go task. Overall, the two patterns of findings suggest important differences in the way ASD and ADHD children remember and realise intentions requiring opposite behaviours (acting vs stopping).     

Order or disorder? Impaired Hebb learning in dyslexia

The present study offers an integrative account proposing that dyslexia and its various associated cognitive impairments reflect an underlying deficit in the long-term learning of serial-order information, here operationalized as Hebb repetition learning. In nondyslexic individuals, improved immediate serial recall is typically observed when one particular sequence of items is repeated across an experimental session, a phenomenon known as the Hebb repetition effect. Starting from the critical observation that individuals with dyslexia seem to be selectively impaired in cognitive tasks that involve processing of serial order, the present study is the first to test and confirm the hypothesis that the Hebb repetition effect is affected in dyslexia, even for nonverbal modalities. We present a theoretical framework in which the Hebb repetition effect is assumed to be a laboratory analogue of naturalistic word learning, on the basis of which we argue that dyslexia is characterized by an impairment of serial-order learning that affects language learning and processing.