Cognitive behavioural and neuropsychiatric treatment of post-traumatic conversion disorder: a case study

Conversion disorder consists of involuntary sensory or motor symptoms and deficits that cannot be explained by a general medical condition. There are several treatment options, although none has emerged as the treatment of choice. The present case study examined the effects of adding cognitive behaviour therapy to neuropsychiatric management of conversion disorder (motor subtype). The patient, a retired emergency services worker, presented with a history of intermittent episodes of speech disruption (inability to speak or difficulty speaking properly). Although episodes of speech disturbance sometimes occurred unexpectedly, they were more likely to occur under conditions of stress and fatigue, and were triggered by reminders of work-related traumatic events. The patient was treated with pharmacotherapy and psychoeducation from a neuropsychiatrist. With the aim of improving treatment outcome, cognitive behaviour therapy was added, involving imaginal exposure to trauma memories, along with cognitive restructuring. The frequency of between- and within-session speech disturbance episodes declined over the course of cognitive behaviour therapy to the point that the patient was essentially symptom-free. Within-session distress ratings also decreased, which suggested habituation to trauma-related memories. This case study demonstrates how particular cognitive behaviour therapy interventions can be usefully applied to one form of conversion disorder.     

Site-selective N-methyl-D-aspartate and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate antagonists produce distinct effects in rats performing complex discriminations

Glutamate receptor-dependent neural plasticity is thought to be implicated in memory processes. Ionotropic N-methyl-D-aspartate- (NMDA) sensitive and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate- (AMPA) sensitive glutamate receptors have been particularly studied for their role in synaptic plasticity. Drugs can alter AMPA and NMDA receptor neurotransmission by competing for the glutamate site or other sites on these receptor proteins. Variants of the protein subunits forming AMPA and NMDA heteromers contribute to the complexity of pharmacological activity at these receptors. The NMDA receptor has numerous modulatory centers, including the glycine binding site, NR2B protein specific binding site, and an intrachannel (PCP) binding site. In this study, the accuracy and rate of rats performing under a Fixed Consecutive Number (FCN) operant task were measured after administrations of site-selective AMPA and NMDA receptor modulators. Test compounds included two glycine site NMDA agonists [(+)HA 966 and D-cycloserine], two NR2-B site NMDA antagonists (eliprodil and ifenprodil), an NMDA channel blocking antagonist (MK 801), and a competitively acting AMPA receptor antagonist (NBQX). The accuracy of FCN performance was not affected by response-rate-altering doses of (+) HA 966, D-cycloserine, eliprodil, ifenprodil, or NBQX. MK 801, on the other hand, reduced performance accuracy at several doses. These results are consistent with earlier studies suggesting that AMPA antagonists minimally affect working memory and that glycine and NR2B protein-specific modulatory sites may have advantages as targets for the development of medications intended to alter NMDA receptor-mediated transmission.     

Adaptive motor behavior of cerebellar patients during exposure to unfamiliar external forces

The authors investigated adaptation of goal-directed forearm movements to an unknown external viscous force assisting forearm flexion in 6 patients with cerebellar dysfunction and in 6 control participants. Motor performance was generally degraded in cerebellar patients and was markedly reduced under the force condition in both groups. However, patients and controls were able to adapt to the novel force within 8 trials. Only the healthy controls were able to improve motor performance when readapting to a null-force condition. The results indicate that cerebellar patients' motor control system has imprecise estimations of actual limb dynamics at its disposal. Force adaptation may have been preserved because single-joint movements were performed, whereas the negative viscous force alone and no interaction forces had to be compensated.     

Exploring Latent Profiles of Psychopathology in a Sample of Lonely People Seeking Treatment

Journal of Psychopathology and Behavioral Assessment - Loneliness is a common experience in populations experiencing mental health problems. Associations with symptoms of psychopathology are...     

A response to Penrose’s “Sandel on enhancement: A response to Van Niekerk”

In this article the author responds to Brian Penrose’s critical response to his (Van Niekerk’s) article “Biomedical enhancement and the pursuit of mastery and perfection: a critique of the views of Michael Sandel” that appeared in the PSSA conference edition of the SAJP 33(2), 2014. While Van Niekerk is appreciative of the opportunity for spirited dialogue that Penrose’s response provides, he nevertheless takes issue with several charges Penrose raises. He responds to Penrose’s claims that Van Niekerk does not fully understand “the Sandel project” and thus that Van Niekerk creates and shoots down a straw man in his argument against Sandel. Van Niekerk argues that Penrose’s claims are indicative of significant methodological differences between their respective approaches. Penrose acknowledges the “fuzziness” of Sandel’s arguments with regards to biomedical enhancement. He then develops an interpretation of Sandel’s views that claims to have “filled in the complete picture” of what Sandel attempts to do, and then reproaches Van Niekerk for not responding to that “completed picture”, i.e. the “Sandel project”. Van Niekerk finds this to be an unreasonable and methodologically highly problematic demand on him. Van Niekerk responds to a number of Penrose’s arguments, and then concludes that while there are, of course, good reasons to exercise caution at the prospect of biomedical enhancement with regard to its risks, the possibilities offered by enhancement need not elicit a prima facie reaction of pessimism. Rather, such prospects can also be regarded in a positive light as an exciting opportunity to take our own evolution in hand.     

Self-directedness and the susceptibility to distraction by saliency

People with low Self-directedness (SD) tend to explain their behaviour as being significantly influenced by events in the external environment. One important dimension of external cues is their level of salience: highly salient external stimuli are more likely to capture attention, even when such stimuli are not relevant to goals. We examined whether adults reporting low SD would exhibit greater susceptibility to distraction by highly salient external stimuli. Fifty-four (42 males) subjects completed the Attention Modulation by Salience Task (AMST) measuring reaction times to early- or late-onset auditory stimuli in the presence of high- or low-salience visual distractors. SD was assessed via self-report, and analyses tested the relationship between SD and performance on the AMST. Results showed a slowed early response to auditory cues during high salience compared to low salience. Indeed, individuals reporting low SD showed stronger salience interference, suggesting that external causality attribution is accompanied by a subconscious perceptual deficit.     

Comparison of impulsiveness, venturesomeness and empathy (I7) structure in English and Spanish samples: Analysis of different structural equation models

The present study analyzed the factorial structure of the I₇ Impulsiveness questionnaire (Impulsiveness, Venturesomeness and Empathy) with a Spanish sample of 742 males and 1.075 females, through exploratory and confirmatory factorial analysis. In relation to the original English data, a three-factor structure showed global congruency coefficients of 0.92 and 0.94 for men and women. Venturesomeness had a modest congruency for males (0.83). A cross-validation analytical strategy showed that the 24-item I₇ was invariant only for the female sample. A subsequent exploratory factor analysis with 24 items showed a sound factor structure. The 24-item version showed the best and most robust structure and similar internal consistency coefficients in regard to the 54-item version. No important differences were founded between I₇ long and short versions with impulsiveness scales of ZKPQ, BIS-10 and SPSRQ.     

The cross-cultural generalizability of Zuckerman's alternative five-factor model of personality

The aim of this study was to analyze the cross-cultural generalizability of the Alternative five-factor model (AFFM; Zuckerman, Kuhlman, & Camac, 1988). The total sample was made up of 9,152 subjects from six countries: China, Germany, Italy, Spain, Switzerland, and the United States. The internal consistencies for all countries were generally similar to those found for the normative American sample. Factor analyses within cultures showed that the normative American structure was replicated in all cultures; however, the congruence coefficients were slightly lower in China and Italy. A similar analysis at the facet level confirmed the high cross-cultural replicability of the AFFM. Mean-level comparisons did not always show the hypothesized effects. The mean score differences across countries were very small.     

Extraversion and neuroticism in team sport participants, individual sport participants, and nonparticipants

Scores on Extraversion and on Neuroticism as measured by the Eysenck Personality Inventory were compared for 90 undergraduate team sport participants, individual sport participants, and nonparticipants (43 men, 47 women, M age = 20.3 yr.). From past research and Eysenck's biological theory of personality, it was hypothesized that sport participants would score higher on Extraversion and lower on Neuroticism than nonparticipants, and that team participants would score higher on Extraversion and perhaps higher on Neuroticism than individual sport participants. By comparing scores for students in first year and final year, it was also investigated whether pre-existing personality differences drew people to sport (the gravitational hypothesis) or whether personality changed as a function of sport participation (the developmental hypothesis). The main findings were that team participants scored higher on Extraversion than both individual sport participants and nonparticipants, and that test scores did not change over time, supporting the gravitational hypothesis for Extraversion.