Adverse-effect profile of kava

The use of alternative therapies has increased substantially over the last decade, particularly for more chronic conditions such as anxiety. Among the most widely used treatments are medicinal herbs, or phytomedicines, such as kava (Piper methysticum), which has demonstrated anxiolytic activity in both animal models and clinical samples. Kava has several advantages over conventional pharmacologic treatments for anxiety--in clinical settings it has been associated with better tolerability and lack of physiologic dependence and withdrawal. However, phytomedicines are not rigorously regulated in the United States and systematically collected safety data are very limited. These issues are a leading concern regarding the safety of medicinal herbs such as kava. In this report, the safety profile for kava is provided, including findings from a study of its use in generalized anxiety disorder. Safety parameters assessed include occurrence of adverse events, withdrawal symptoms, effect on heart rate, blood pressure, laboratory assessments, and sexual function. No differences were found between kava and placebo on any of the parameters evaluated. The data support the safety of kava in treating anxiety at 280 mg kava lactones/day for 4 weeks.     

Response-dependent point loss and response force as disrupting operations on behavioral resistance to change in humans

Behavioral momentum theory (BMT) provides a theoretical and methodological framework for understanding how differentially maintained operant responding resists disruption. A common way to test operant resistance involves contingencies with suppressive effects, such as extinction or prefeeding. Other contingencies with known suppressive effects, such as response-cost procedures arranged as point-loss or increases in response force, remain untested as disruptive events within the BMT framework. In the present set of three experiments, responding of humans was maintained by point accumulation programmed according to a multiple variable-interval (VI) VI schedule with different reinforcement rates in either of two components. Subsequently, subtracting a point following each response (Experiment 1) or increasing the force required for the response to be registered (Experiments 2 and 3 decreased response rates, but responding was less disrupted in the component associated with the higher reinforcement rate. The point-loss contingency and increased response force similarly affected response rates by suppressing responding and human persistence, replicating previous findings with humans and nonhuman animals when other types of disruptive events (e.g., extinction and prefeeding) were investigated. The present findings moreover extend the generality of the effects of reinforcement rate on persistence, and thus BMT, extending the analysis of resistance to two well-known manipulations used to reduce responding in the experimental analysis of behavior.     

Brain potentials to emotional pictures are modulated by alexithymia during emotion regulation

Alexithymia is a personality trait associated with the reduced ability to regulate, identify, and communicate feelings or emotions and is often linked to psychosomatic disorders. The present study used event-related potentials (ERPs) to investigate the relationship between individual differences in alexithymia and emotion regulation. Participants classified as scoring either high or low on the revised form of the Toronto Alexithymia Scale (TAS-20; Taylor, Bagby, & Parker Psychother Psychosom 57:34–41, 1992) were asked to view negative and neutral images, adopting three different regulation strategies (expressive suppression, cognitive reappraisal, and attend) while ERPs were recorded. Results revealed an inverse relationship between TAS scores and emotion-related ERP activity during suppression, but not during reappraisal or a control “attend” condition. These results were observed in both early and late ERP latencies. These findings are interpreted according to potential differences between high- and low-TAS individuals regarding the frequency of prior utilization of suppression-based regulation strategies.     

Faces differing in attractiveness elicit corresponding affective responses

We examined whether faces differing in attractiveness elicit positive and negative affect in 7- to 10-year-old children (N=66) and adults (N=73). Facial electromyography measured affective response. Less attractive faces evoked significantly more levator labii superioris responses in adults and children. Attractiveness was negatively correlated with corrugator supercilii activity in adults, but not significantly in children. These results suggest that less attractive faces evoke greater disgust and negative affect than more attractive faces. Perceivers' affective reactions to attractive faces may play an important role in attractiveness preferences and attractiveness stereotypes.     

The effectiveness of dialectical behaviour therapy in routine public mental health settings: An Australian controlled trial

Randomised controlled studies in research environments have demonstrated dialectical behaviour therapy (DBT) to be more efficacious than treatment as usual in reducing suicidal behaviour in patients with borderline personality disorder (BPD). Limited evidence exists for the effectiveness of DBT in the treatment of BPD within routine clinical settings. This study examines the clinical and cost effectiveness of providing DBT over treatment as usual in a routine Australian public mental health service. Forty-three adult patients with BPD were provided with outpatient DBT for six months with patient outcomes compared to those obtained from patients in a wait list group receiving treatment as usual (TAU) from the same service. After six months of treatment the DBT group showed significantly greater reductions in suicidal/non-suicidal self-injury, emergency department visits, psychiatric admissions and bed days. Self-report measures were administered to a reduced sample of patients. With this group, DBT patients demonstrated significantly improved depression, anxiety and general symptom severity scores compared to TAU at six months. Average treatment costs were significantly lower for those patients in DBT than those receiving TAU. Therapists who received intensive DBT training were shown to produce significantly greater improvements in patients’ suicidal and non-suicidal self-injury than therapists who received only 4 day basic training. Further clinical improvements were achieved in patients offered an additional six months of DBT. This study demonstrates that providing DBT to patients within routine public mental health settings can be both clinically effective and cost effective.     

Comparative Psychopathology of Suicide Attempts and Assaults

ABSTRACT: Using the Katz Adjustment Scales to measure psycho-pathology, systematic samples of 108 suicide attempters and 42 persons arrested for assault were tested in Baltimore, Maryland. The subjects' scores were compared with ratings by third-party respondents, who knew the subjects well, and with scores of 450 controls. Both suicide attempters and assaulters displayed significantly more psychopathology than the controls. The suicide attempters were differentiated from the assaulters on six Katz items: Helplessness, Anxiety, Nervousness, Depression, Stability, and General Psychopathology. An attempt was made to refine prediction and control of these two different life-threatening behaviors by interpreting the data in terms of Henry and Short's concept of “internal restraint.”