Exploration of anomalous perceptual experiences in migraine between attacks using the Cardiff Anomalous Perceptions Scale

Distortions in sensory experiences that precede a migraine attack have been extensively documented, the most well-known being the visual aura. Distortions in the experience of other senses are also reported as part of an aura, albeit less frequently, together with changes in the perception or ownership of the body or body parts. There are many examples of differences in aspects of visual perception between migraine and control groups, between attacks, but not as much on unusual experiences involving other senses, the sense of the body or the experience of the environment. Seventy-seven migraine (33 with aura) and 74 control participants took part. Anomalous perceptions were experienced by both migraine and control groups, but more with migraine experienced them and rated them as more distressing, intrusive and frequent. Associations with reports of visual triggers of migraine and visual discomfort are presented. This study is the first to show relationships between these factors.     

Consciousness and modality: on the possible preserved visual consciousness in blindsight subjects

In a recent paper, Brogaard (2011) presents counter-arguments to the conclusions of an experiment with blindsight subject GR. She argues that contrary to the apparent findings that GR’s preserved visual abilities relate to degraded visual experiences, she is in fact fully unconscious of the stimuli she correctly identifies. In this paper, we present arguments and evidence why Brogaard’s argument does not succeed in its purpose. We suggest that not only is relevant empirical evidence in opposition to Brogaard’s argument, her argument misconstrues necessary criteria to decide whether a conscious experience is visual or not visual.     

A second Leonardo da Vinci?

We describe a young woman who suddenly began mirror writing with her right hand and has not reverted to normal writing for more than 6 years, although she writes normally with her left hand. She is ambidextrous, although she had previously used only her right hand for writing and drawing. Since it is much easier for her to use right-handed mirror writing, she uses her left hand only for writing meant to be read by others and her right hand for all other writing. Her hobbies are sculpture and painting, and her chief complaint is migraine accompanied by sensory and perceptive disturbances.     

Disorders of oculomotor scanning and graphic orientation in developmental Gerstmann syndrome

A patient with developmental Gerstmann syndrome who experiences great difficulty in performing tasks requiring visuoconstructive and reading abilities is described. Neuropsychological assessment revealed normal range verbal abilities but severe deficits in directional orientation, finger differentiation, calculational ability, copying, and reading ability. Achievement in reading was measured at the sixth-grade level despite the fact that this patient is a third-year college student. Using infrared photoelectric sensors, we monitored the horizontal saccades of this patient while reading from a standardized reading test. Fixation durations were not abnormal. However, instances of reverse-staircase movement were exhibited. While reading from an inverted test, she showed a normal eye-movement pattern (although in the reverse direction since the task now called for right-to-left saccades). The processing of spatial information in this patient is severely disturbed and this may account for the apparently abnormal oculomotor scanning, an “irrepressible tendency” to move her eyes in a right-to-left direction.     

Preserved and Impaired Detection of Structure From Motion by a 'Motion-blind" Patient

Following bilateral extrastriate damage to areas that include the suspected human homologue of V5/MT, the patient LM has a specific deficit in processing moving stimuli. She has difficulty detecting the movement or coding the velocity of single moving dots. Nevertheless, we find that she can report human actions in Johansson “biological motion ”; displays. This requires the accurate coding of the direction and velocity of many moving dots. The implication is that structure can be extracted from motion in regions of visual cortex other than those traditionally associated with motion processing. However, she cannot report the spatial disposition of the actors whose actions she has recognized, not their movement in depth relative to her. A possible interpretation is that coding in these additional regions is primarily object-centred. Adding a small number of random stationary “noise” dots to the display prevents her from identifying the actions, suggesting that segregation by motion is implemented within the traditional movement areas.     

Unawareness of impaired face recognition

We report investigations of the face processing abilities of SP, a right-handed woman who had suffered a subarachnoid haemorrhage from a right middle cerebral artery aneurysm. Although she could correctly assign visual stimuli to the 'face' category without difficulty, SP performed poorly on all other face processing, tasks, including 'closure' (Mooney faces), perception of facial expression, unfamiliar face matching, and identification of familiar faces. Identification of familiar people from nonfacial cues (names) remained relatively well-preserved, but severe impairments were evident on all face recognition tasks. Her errors mostly involved either failures to find a face familiar at all, or misidentification as another familiar person. In face-name learning tasks, there was evidence of 'covert' recognition of faces she failed to recognize overtly. SP's face processing impairment remained stable across a 20-month period of investigation, yet throughout this period she did not think that she had any problems in face recognition, and continued to show lack of insight into this impairment even when directly confronted with its consequences on formal testing. In contrast, SP showed adequate insight into other physical and cognitive impairments produced by her illness, including poor memory, hemiplegia, and hemianopia. We propose that her lack of insight into her face recognition problems involves a deficit-specific anosognosia, resulting from impairment of domain-specific monitoring abilities.     

Toward a Psychophysics of Perceptual Organization Using Multistable Stimuli and Phenomenal Reports

We explore experimental methods used to study the phenomena of perceptual organization, first studied by the Gestalt psychologists. We describe an application of traditional psychophysics to perceptual organization and offer alternative methods. Among these, we distinguish two approaches that use multistable stimuli: (1) phenomenological psychophysics, in which the observer's response is assumed to accurately and directly reflect perceptual experience; and (2) the interference paradigm, in which an observer's response is evaluated as correct or incorrect because it pertains to a corrigible task, but does not directly reflect the observer's experience. We show that phenomenological psychophysics can yield valuable information about perceptual organization and lends itself to the development of quantitative theory. We discuss some criticisms of the method and argue that the two approaches that use multistable stimuli are complementary. We also compare each of the approaches with traditional psychophysics. We conclude that the several methods are convergent.     

Toward ecologically realistic theories in visual short-term memory research

Recent evidence from neuroimaging and psychophysics suggests common neural and representational substrates for visual perception and visual short-term memory (VSTM). Visual perception is adapted to a rich set of statistical regularities present in the natural visual environment. Common neural and representational substrates for visual perception and VSTM suggest that VSTM is adapted to these same statistical regularities too. This article discusses how the study of VSTM can be extended to stimuli that are ecologically more realistic than those commonly used in standard VSTM experiments and what the implications of such an extension could be for our current view of VSTM. We advocate for the development of unified models of visual perception and VSTM—probabilistic and hierarchical in nature—incorporating prior knowledge of natural scene statistics.     

Schlafstörung

A 41 year-old woman presented with restlessness and constricting and pressing dysesthesia in both calves and feet. These symptoms bother her especially in the evening while watching TV and later while lying in bed. She has to stand up repeatedly and walk around in her flat to obtain some temporary relief of her symptoms, which first appeared during her pregnancy 6 years ago and have become gradually worse over time. The patient complains that nowadays she lies awake in bed for up to 2 h until she can go to sleep several times a week. She wakes up 2–3 times a night only to find herself fighting to go back to sleep. During the day she noticed difficulties concentrating during work and frequently reacts angrily towards her husband and her daughter.     

Demonstrating a wordlikeness effect on nonword repetition performance in a conduction aphasic patient

The purpose of this study was to identify the nature of the deficit for a conduction aphasic patient in order to evaluate two different theories of conduction aphasia. First, a conduction aphasic patient FS was tested on auditory word-pair discrimination, word-repetition, and picture-naming. The results of these tasks indicated that her deficit was likely to be post-lexical rather than perceptual or lexical. Next, we examined her repetition performance for two types of nonwords (high-wordlike and low-wordlike nonwords) to distinguish the two theories. FS exhibited a wordlikeness effect: she produced more correct moras and more correct combinations of moras for high-wordlike nonwords than low-wordlike nonwords. We conclude that she had difficulty in maintaining stable phonological representations of verbal materials in the output buffer.     

Inhibiting the mentalizing capacities

This paper describes a phobic patient who inhibited her capacity to mentalize defensively in situations when emotionally overwhelmed. When provoked by anxiety, she used the ‘silencing-method’, not reflecting on her internal world or her relationships. In order to avoid painful thinking, she stopped mentalizing and used practical or physical activities as a psychic retreat from an unpleasant reality. In psychoanalysis, she developed a growing tolerance to conceiving her own mental states However, even after several years of analysis, inhibiting her mentalizing capacities remained her defensive strategy. This paper suggests that phobia could be understood as an intolerance of conceiving mental states, preventing integration of psychic trauma. Improvement of the mentalizing capacities through psychoanalysis makes phobic symptoms fade.     

A body with chronic fatigue syndrome as a battleground for the fight to separate from the mother

I describe the therapy of a 20-year-old woman who believed that her difficulties in concentrating and remembering were caused by her 'ME' (Myalgic encephalomyelitis, Chronic fatigue syndrome, or CFS). She had been fathered by a man who never left his own wife. Work with her dreams revealed a within-body drama in which she was locked in an unspeakable fight to the death with her mother. Her symptoms improved after parallels between a dream and an accident showed her own self-destructive hand in her story. Another dream, reflecting her first 'incestuous' affair, showed her search for her original father-self as someone separate from mother, and a later affair provided a between-body drama, helping her to own the arrogant and abject traits she had before seen only as her mother's. I show how we worked in the area of Winnicott's first 'primitive agony' as experienced by a somatizing patient, stuck in a too-close destructive relationship with her mother-body. I discuss how analytical work can be done with the primitive affects and conflicts against which the ME symptoms may be defending.     

The affective consequences of cognitive inhibition: devaluation or neutralization?

Affective evaluations of previously ignored visual stimuli are more negative than those of novel items or prior targets of attention or response. This has been taken as evidence that inhibition has negative affective consequences. But inhibition could act instead to attenuate or "neutralize" preexisting affective salience, predicting opposite effects for stimuli that were initially positive or negative in valence. We tested this hypothesis by presenting trustworthy and untrustworthy faces (Experiment 1), strongly positive and negative photographs (Experiment 2), and monetary gain- and loss-associated patterns (Experiment 3) in a Go/No-Go task and assessing subsequent affective ratings. Evaluations of prior No-Go (inhibited) stimuli were more negative than of prior Go (noninhibited) stimuli, regardless of a priori affective valence. Ratings of No-Go stimuli also became increasingly negative (vs. increasingly neutral) when preexisting salience was increased via stimulus repetition (Experiment 4). Our results suggest inhibition leads to affective devaluation, not affective neutralization.     

A Comparative Assessment of an Analysis of Envy: Commentary on Paper by Julie Gerhardt

This discussion is introduced with emphasis on the need for comparative psychoanalytic studies in our pluralistic psychoanalytic world and describes an approach to such an endeavor. A very brief comment on the extensive literature review is followed by a more detailed focus on the “analysis of envy,” which gradually changed into the analysis of the patient, as a person. The discussant's “empathic entry” into the analyst's mode of listening and responding was simultaneously also applied to the patient's experience, to see how well patient and analyst communicated with each other and whether or not the patient indicated that she felt understood or not. When she did not feel understood, the patient signaled this with an intensification of her envy into furious “envy attacks.” The analyst's “decoding interpretations” implied that the patient was causing her own problems and should not feel the way she did. The analyst discovered this later herself. Her discoveries in the fourth year of the analysis yielded notable changes both in her approach and in the patient's progress. Ultimately, the analyst allowed her subjectivity to enter the analysis and became better amalgamated with her chosen theory, leading to the changes in a progressively more fruitful analysis.     

Visual identification following inferotemporal ablation in the monkey

Nine monkeys took part in two experiments on visual learning and the effect of inferotemporal ablation. The first experiment contrasted lesion effects in two tasks given to separate groups of animals: serial visual reversal learning set with only two visual stimuli in use throughout the experiment, and discrimination learning set with a new pair of visual stimuli for each discrimination problem. Following inferotemporal ablation, the within-reversal learning rate recovered to the normal pre-operative level, while within-problem learning in discrimination learning set remained substantially impaired. This result suggests that inferotemporal ablation does not directly impair visual associative learning, but rather produces a defect in visual identification such that only a small set of familiar stimuli can be correctly identified and associated with reward. The second experiment replicated an earlier experiment in showing that monkeys with inferotemporal ablation could learn at a normal rate to choose between stimuli according to their spatial orientation. A relation between the two types of unimpaired visual learning in the operated animals was suggested and analogies with clinical syndromes were discussed. The experimental results were interpreted within a distributed-trace model of learning, and this interpretation was illustrated and supported by a computer simulation presented in the Appendix.     

When do auditory/visual differences in duration judgements occur?

Four experiments examined judgements of the duration of auditory and visual stimuli. Two used a bisection method, and two used verbal estimation. Auditory/visual differences were found when durations of auditory and visual stimuli were explicitly compared and when durations from both modalities were mixed in partition bisection. Differences in verbal estimation were also found both when people received a single modality and when they received both. In all cases, the auditory stimuli appeared longer than the visual stimuli, and the effect was greater at longer stimulus durations, consistent with a “pacemaker speed” interpretation of the effect. Results suggested that Penney, Gibbon, and Meck's (2000) “memory mixing” account of auditory/visual differences in duration judgements, while correct in some circumstances, was incomplete, and that in some cases people were basing their judgements on some preexisting temporal standard.     

The functional anatomy of a hysterical paralysis

The concept of a conversion disorder (such as hysterical paralysis) has always been controversial (Ron, M.A. (1996). Somatization and conversion disorders. In: B.S. Fogel, R.S. Schiffer & S.M. Rao (Eds.), Neuropsychiatry. Williams and Wilkins, Baltimore, MD). Although the diagnosis is recognised by current psychiatric taxonomies, many physicians still regard such disorders either as feigned or as failure to find the responsible organic cause for the patient's symptoms. We report a woman with left sided paralysis (and without somatosensory loss) in whom no organic disease or structural lesion could be found. By contrast, psychological trauma was associated with the onset and recurrent exacerbation of her hemiparalysis. We recorded brain activity when the patient prepared to move and tried to move her paralysed (left) leg and when she prepared to move and did move her good (right) leg. Preparing to move or moving her good leg, and also preparing to move her paralysed leg, activated motor and/or premotor areas previously described with movement preparation and execution. The attempt to move the paralysed leg failed to activate right primary motor cortex. Instead, the right orbito-frontal and right anterior cingulate cortex were significantly activated. We suggest that these two areas inhibit prefrontal (willed) effects on the right primary motor cortex when the patient tries to move her left leg.     

"The W and M are mixing me up": use of a visual code in verbal short-term memory tasks

When normal participants are presented with written verbal short-term memory tasks (e.g., remembering a set of letters for immediate spoken recall) there is evidence to suggest that the information is re-coded into phonological form. This paper presents a single case study of MJK whose reading follows the pattern of phonological dyslexia. In short-term memory tasks MJK does not phonologically re-code written materials but, it is argued, uses a visual code. There are three main lines of evidence for this, (a) MJK tends to substitute visually similar items for one another, (b) her performance is better with visual than auditory stimuli, and (c) she is able to remember numbers (e.g., 8) better than written words (e.g., eight). Investigation of short-term memory in others with phonological dyslexia is warranted.