Is anorexia nervosa a neuropsychological disease?

Evidence for central nervous system, and more particularly cortical, etiology of anorexia nervosa is reviewed. Topics covered are neuropsychiatric comorbidity, inheritance patterns, the neurobiology of body-image disturbance and of the eating function, perinatal and alcoholic insult to the brain, neurochemical and neuroelectric disturbance, anatomic and metabolic brain imaging, and neuropsychological impairment. It is concluded that there is indeed an important neuropsychological etiological dimension to anorexia nervosa. The profile most frequently associated with anorexia nervosa is right posterior hypometabolism, followed by right anterior hypermetabolism, both associated with right-sided abnormal electroencephalogram spiking. It is also proposed that bulimia consists of a positive neurological subtype and that restricting anorexia represents a negative neurological subtype. Priorities for further research into anorexia nervosa are specified to include twin adoption studies, brain electrical topography studies, postmortem histological studies, and experimentally inspired neuropsychological studies.     

Multiple listing for organ transplantation: autonomy unbounded

Recently, debate about the distribution of scarce organs for transplantation has focused on whether patients should have the right to place themselves on waiting lists at several transplant centers, thereby gaining an advantage over other potential recipients. This article explores the social and ethical issues raised by multiple listing, contrasting policies adopted at the national level with those implemented in New York State. It concludes by examining the implications of the debate for broader questions about entitlement and access to health care.     

Work,leisure, and psychological well-being in a sample of young adults

This study of 20 ‘white-collar’ workers aged 20–30 measured motivation, enjoyment and access to various categories of experience in both work and leisure, and examined their relationship with psychological well-being on a number of dimensions. The method used a short questionnaire, psychological scales and the innovatory ‘experience sampling methodology’ (ESM) where respondents answer questions in a diary on the receipt of a signal from a pre-programmed watch or radio pager eight times a day for 1 week. The results show, in line with other studies, that intrinsic motivation in daily life is correlated with happiness but that, not previously reported, when motivation at work is examined both extrinsic motivation and instances where a person had to do the activity but did not wish to be doing something else, i.e. ‘positive motivational change’, are correlated with positive aspects of psychological well-being, while instances where a person wanted to do the activity but wished to be doing something else, i.e. ‘negative motivational change’, correlated with negative aspects. The results also show that enjoyment in both work and leisure correlates with aspects of psychological wellbeing; and that macro ‘flow’ experiences, where high skills and high challenges are perceived as equal, are enjoyable and interesting and come primarily from work. The study also shows that categories of experience considered important for psychological well-being and deemed to come primarily from work can be obtained in leisure. The results are discussed in the context of person—situation interactions and processes, and it is advocated that these should be studied in a variety of samples.     

Case vignette: premature surrender

Three commentaries are offered on the following case: George, age 57, is a previously healthy man who recently underwent surgery for removal of a low-grade malignant thymoma. At the time of admission to the hospital, George stressed to the staff that he had long ago signed a "living will," which he renewed immediately after he learned of his cancer diagnosis. At the time of surgery, the tumor was found to extend into his mediastinum; although it was removable, this required revision of part of the sternum and grafting of the vessels feeding the heart chambers. Because of the resultant tissue damage and neuronal hyperactivity, George experienced postoperative episodes of cardiac arrhythmia and bronchospasm. Unanimous medical opinion was that this situation was a temporary problem that would resolve itself as the tissues healed. Until that time, however, it will be difficult to wean him from ventilatory support. When his stay in the intensive care unit became prolonged, George and his family began to insist that his status be changed to "do not resuscitate" and reminded the staff about his longstanding living will. All of this is happening despite the fact that the patient and family seemingly comprehend that although the short-term interventions are invasive, there is a high probability of a successful outcome. George's cancer prognosis is excellent, and, although he may well have an episode of life-threatening arrhythmia, he is likely to respond to resuscitation interventions. Once the immediate postoperative period is over, his potential for a long and productive life with full capacities is excellent. Consider the following questions: (a) Should George's expressed wishes be respected, or should the staff take additional steps to help him survive the postoperative period, even if that means violating his stated wishes? and (b) What steps might the staff follow in sorting through this problem?     

Subjective contours 1900–1990: Research trends and bibliography

Abibliography on subjective contours and a brief summary of trends in research-on-thin problem are presented. The bibliography covers the years 1900–1990 and contains 445 entries, each briefly annotated with a code that indicates the general content and theoretical orientation of the item.     

Haptic probing: Perceiving the length of a probe and the distance of a surface probed

Knowing about the properties of objects by wielding them and knowing about the distances of surfaces by striking them with objects as probes are examples of dynamic or effortful touch. Six experiments focused on the invariant mechanical parameters that couple the time-varying states (displacements, velocities) of hand-held rods to the time-varying torques and forces imposed upon them by wielding and probing. There were three major conclusions. First, when a probe is wielded without contact, perceived probe length is a function of the probe’s rotational inertia; however, with contact, perceived probe length is affected by the rotational inertia and the distance of the point of contact from the probe’s center of percussion. Second, when a surface is struck with a probe, perceived surface distance is affected by the probe’s rotational inertia and the angle of inclination of the probe at contact. Third, under seemingly identical conditions of probing, either probe length or surface distance can be perceived selectively without confusion. Results were discussed in terms of haptic information, haptic attention, and the dynamics of probing.     

Minimizing the number of observations: A generalization of the spearman-brown formula

A new method for determining the minimum number of observations per subject needed to achieve a specific generalizability coefficient is presented. This method, which consists of a branch-and-bound algorithm, allows for the employment of constraints specified by the investigator.     

Attenuation of amphetamine-stereotypy by mesostriatal dopamine depletion enhances plasma corticosterone: implications for stereotypy as a coping response

The relationship between amphetamine-induced stereotyped behavior and a neuroendocrine index of arousal, plasma corticosterone (CCS), was investigated. 6-Hydroxydopamine lesions of the caudate-putamen, which produced dopamine depletions of 60%, blocked stereotypy and prolonged the elevation in corticosterone associated with d-amphetamine treatment (5 mg/kg). Similar dopamine depleting lesions of the nucleus accumbens, which attenuated the locomotor, but not the stereotypic, response to AMPH did not have this effect on CCS. This pattern of results supports the hypothesis that stereotypy has a coping function which may serve to alter arousal and further suggests important differences between the nigrostriatal and mesolimbic dopamine projections in modulating the responsiveness of the neuroendocrine system. These results have implications for understanding the function of behavioral stereotypies common to a number of psychopathological conditions, including schizophrenia and childhood autism.     

Synaptic plasticity in the hypoglossal nucleus of female canaries: structural correlates of season, hemisphere, and testosterone treatment

The caudal portion of the hypoglossal nucleus (nXIIts) contains the motor neurons that control the syrinx in songbirds. In canaries, song occurs seasonally, is principally produced by males, and appears to be produced predominantly by muscles on the left side of the syrinx. The present study measures the effect of seasonal change and manipulation of testosterone levels on synapse number and morphology in nXIIts in adult female canaries. We find that synapse density is lower in testosterone-treated birds than in control birds and lower in fall than in spring. The number of vesicles per presynaptic profile increases in the spring as a result of a general increase in this measure in all synapses. The number of vesicles per presynaptic profile also increases with testosterone treatment, primarily due to an increase in the proportion of synapses associated with unusually high vesicle counts. Together, these changes suggest that large reserves of neurotransmitter may be necessary to sustain singing. Several ultrastructural differences between hemispheres are found. Postsynaptic thickenings are longer, and postsynaptic processes are larger on the left side than on the right side. In the spring, there are more vesicles per synapse on the left than on the right, but this lateralization is reversed in the fall. Thus, lateralization of song production is associated with lateral asymmetries in synapse morphology. These hemispheric differences are relatively small, like those seen at the light microscope level, encouraging further consideration of peripheral as well as CNS sources of functional lateralization. The seasonal and testosterone-induced changes in synapse number and morphology may be components of the periodic reorganization of canary vocalization.     

Physical fitness, body image, and locus of control in college freshman men and women

This study examined the relations among physical fitness, body image, and locus of control. The Hall-Physical Fitness Test Profile, the Winstead and Cash Body Self-relations Questionnaire (BSRQ) and the Nowicki-Strickland Locus of Control Scale were administered to 243 freshmen. Women were significantly more positive about their physical appearance than men. Men were more positive about their physical fitness than women. Men were more physically fit than women. Men and women scoring in the internal direction viewed the physical fitness domain of their body image positively. Unlike men, internally oriented women had more positive perceptions of the health aspect of their body image. Physically fit men and women had positive attitudes toward the physical fitness component of their body image. Physically fit men differed from physically fit women in that men were more internal and held more positive attitudes toward the physical health dimension of their body images.