The neuroendocrinology of posttraumatic stress disorder: new directions

Studies of the hypothalamic-pituitary-adrenal (HPA) axis in persons with posttraumatic stress disorder (PTSD) have produced variable findings. This review focuses on the factors likely to have affected the outcome of these studies, including population characteristics and experimental design. Also discussed is a possible role for the adrenal neurosteroid dehydroepiandrosterone (DHEA) as a mediator of HPA axis adaptation to extreme stress and the psychiatric symptoms associated with PTSD. The antiglucocorticoid properties of DHEA may contribute to an upregulation of HPA axis responses as well as mitigate possible deleterious effects of high cortisol levels on the brain in some PTSD subpopulations. The neuromodulatory effects of DHEA and its metabolite DHEAS at gamma-aminobutyric acid and N-methyl-D-aspartate receptors in the brain may contribute to psychiatric symptoms associated with PTSD. The possible importance of other neurohormone systems in modulating HPA axis and symptom responses to traumatic stress is also discussed. Understanding the complex interactions of these stress-responsive neurosteroid and peptide systems may help explain the variability in patterns of HPA axis adaptation, brain changes, and psychiatric symptoms observed in PTSD and lead to better targeting of preventive and therapeutic interventions.     

Efficacy of telephone-administered cognitive behaviour therapy for obsessive-compulsive spectrum disorders: case studies

Cognitive behaviour therapy is effective for obsessive-compulsive disorder and for obsessive-compulsive spectrum disorders such as trichotillomania. Unfortunately, many people with these disorders, especially those living in rural areas, have limited access to treatment. Telephone-administered cognitive behaviour therapy may help address this problem. In a recent study of telephone treatment for obsessive-compulsive disorder, we found that such treatment was often effective (42% in remission at post-treatment, and 47% in remission at 12-week follow-up). This article presents 2 case reports of the same treatment, applied to obsessive-compulsive spectrum disorders (trichotillomania and compulsive skin picking). Treatment was associated with symptom reduction for both participants, although one subsequently relapsed. Possible reasons for relapse are discussed. The findings encourage further studies to identify the characteristics of people most likely to benefit from telephone treatment for spectrum disorders.     

Behavioral assessment: review and prospect

In this article I review the history and publication trends of the behavioral assessment (BA) section of the journal, outline future directions for the BA section and suggest avenues for future assessment research. BA began as a stand-alone journal in 1978 and was incorporated as a regular section of Behaviour Research and Therapy (BRT) in 1992. Throughout this article I will use 'BA' to refer to both the stand-alone assessment journal and the assessment section of BRT. Since its inception, the scope of BA has been broad, with behavioral assessment defined to include the assessment of motoric, cognitive, emotional and physiological responses. Several publication trends are identified, including a declining frequency in the number of submitted and published articles on behavioural assessment. This parallels the declining number of assessment articles published elsewhere. Despite these trends, assessment research continues to form a vital foundation for other types of psychological research (e.g. treatment outcome studies), and there is a continued need for assessment-related research. A number of potentially fruitful directions for assessment research are suggested.     

Fluency disruption in speech and in wind instrument playing

A case of an adult who stutters and complains of a similar fluency problem when playing the trombone is reported. This is the fourth such report, with previous cases involving trumpet, flute, and horn playing.     

Fleeting Signs of the Course of Life: Facial Expression and Personal Adjustment

In this article, we consider whether facial expressions of emotion relate in theoretically interesting ways to personal adjustment. We first consider the conceptual benefits of this line of inquiry. Then, to anticipate why brief samples of emotional behavior should relate to personal adjustment, we review evidence indicating that facial expressions of emotion correspond to intrapersonal processes and social outcomes. We then review studies showing that facial expressions relate in theoretically significant ways to adjustment after the death of a spouse, in long-term relationships, and in the context of chronic psychological disorders.