Neuropsychological functioning in kleptomania

Kleptomania is characterized by the failure to resist impulses to steal objects not needed for personal use or their monetary value. The objective of this study was to examine cognitive and executive functioning in subjects with kleptomania. Fifteen women with a primary DSM-IV diagnosis of kleptomania underwent a detailed psychiatric examination, including measures of kleptomania severity, and a battery of neuropsychological tests that emphasized executive functions. Correlational analyses were computed between measures of kleptomania severity and tests of executive functioning. Kleptomania subjects reported a mean duration of illness of 17.9 years and shoplifting a mean of 1.7 times per week. All subjects reported an inability to resist urges to shoplift. Neuropsychological testing revealed group mean test scores within 0.5 standard deviations of normative standards for age. Five subjects (33.3%), however, had below-average performance on at least one measure of executive functioning, and 4 (26.7%) had below-average scores on two executive measures. Correlational analyses revealed a statistically significant correlation between kleptomania severity and Wisconsin Card Sorting Test performance (r=-0.693, p=0.004). As a group, subjects with kleptomania did not demonstrate deficits on neuropsychological testing. Greater kleptomania symptom severity, however, was correlated with impairment in executive functioning.     

Intervention Styles With Suicidal Callers at Two Suicide Prevention Centers

Callers to suicide prevention centers are mainly helped by volunteers trained to face these crisis situations. This study evaluated this process of intervention in order to better understand the nature of the interventions and their determinants. A total of 617 calls with suicidal clients were classified with a 20-category rating instrument, the Helper's Response List. Cluster analysis determined that the 617 intervention profiles could match one of two styles: nondirective (“Rogerian”-391 calls) or directive (226 calls). Further analyses indicated that the particular style of intervention was related more to the characteristics of the callers themselves than to characteristics of volunteers.     

Learning about environmental geometry: a flaw in Miller and Shettleworth's (2007) operant model

Many studies have examined how humans and other animals reestablish a sense of direction following disorientation in enclosed environments. Results showing that geometric shape of an enclosure is typically encoded, sometimes to the exclusion of featural cues, have led to suggestions that geometry might be encoded in a dedicated geometric module. Recently, Miller and Shettleworth (2007) proposed that the reorientation task be viewed as an operant task and they presented an associative operant model that appears to account for many empirical findings from reorientation studies. In this paper we show that, although Miller and Shettleworth's insights into the operant nature of the reorientation task may be sound, their mathematical model has a serious flaw. We present simulations to illustrate the implications of the flaw. We also propose that the output of a simple neural network, the perceptron, can be used to conduct operant learning within the reorientation task and can solve the problem in Miller and Shettleworth's model.     

Psychometric Properties of the Locus of Control of Behaviour Scale (LCBS) among Australians Seeking Alcohol and Other Drug (AOD) Treatment

Despite a paucity of studies evaluating the psychometric properties of the Locus of Control of Behaviour Scale (LCBS), it continues to be widely used in behavioural research. The present study sought to redress this gap in the literature. The 17‐item LCBS was administered to 373 Australians attending Alcohol and Other Drug (AOD) treatment agencies in the northern metropolitan region of Perth. Confirmatory factor analyses were conducted in order to determine which of several plausible measurement models provided the best fit for the data. A unidimensional model, recommended by the authors of the LCBS, and a two‐dimensional (Internal Locus of Control vs External Locus of Control) model provided poor fits. Other multidimensional models, differing only in the dimensionality of the externality factor, were also tested. A multidimensional model consisting of an Internal Locus of Control factor and four component External Locus of Control factors provided the best fit; however, the fit is probably best described as “reasonable” rather than “good.” A subsequent exploratory factor analysis using parallel analysis indicated a cohesive internality factor; however, the externality factor showed a tendency to fragment into smaller components. Results were discussed in terms of the problematic externality factor.     

Examining mental health symptoms in male and female incarcerated juveniles

Varying risk factors for both incarceration and mental health diagnoses have been identified for female juveniles, highlighting the need for gender-specific assessments and treatment protocols. The purpose of this study is to determine how the prevalence rates of mental health symptoms differ in male and female juvenile offenders. It was hypothesized that the prevalence rates would be greater for females than males. This study found significant differences between males and females on several clinical scales. These findings are consistent with past studies that have identified differences in mental health symptoms between genders.     

Prevalence of ADHD and its subtypes in male and female adult prison inmates

There are few published studies of attention-deficit/hyperactivity disorder (ADHD) in adult inmates, and even fewer studies that have considered ADHD in adult inmates by gender. The present study examined the prevalence of ADHD, its subtypes, and associated psychological and neuropsychological comorbidity as a function of gender in a sample of 3,962 inmates (3,439 men and 523 women; mean age = 33.6 years, range 17-73) who had completed the 250-item, self-report, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (Text Revision) (DSM-IV-TR)-aligned Coolidge Correctional Inventory (CCI). The overall ADHD prevalence rate found was 10.5%, which is substantially higher than the rate among adults in the general population (2-5%). The female inmate ADHD prevalence rate (15.1%) was higher than the male inmate ADHD rate (9.8%), consistent with some previous studies. The most prevalent ADHD subtype for both genders was the hyperactive-impulsive subtype. The combined and inattentive ADHD subtypes had higher levels of comorbid psychopathology than the hyperactive-impulsive ADHD subtype. As the presence of ADHD and associated gender differentials may impact the success of rehabilitation and educative programs with inmates, the assessment of ADHD and comorbid psychopathology should be a priority in initial inmate screening and evaluation.     

The Clash of Medical Civilizations: Experiencing “Primary Care” in a Neoliberal Culture

An anthropologist describes how he found himself at the vortex of a “clash of medical civilizations:” neoliberalism and the international primary health care movement. His involvement in a $6 million social change initiative in medical education became a basis to unlock the hidden tensions, contradictions and movements within the “primary care” phenomenon. The essay is structured on five ethnographic stories, situated on a continuum from “natural” species-level primary care to “unnatural” neoliberal primary care. Food is an element of all tales. Taking the long view of history/prehistory permits us to better recognize ideological distortions in order to more capably transform medicine.