Somnambulism induced by quetiapine: two case reports and a review of the literature

Somnambulism, a previously unreported side effect of quetiapine, is described in two cases. Both cases involved individuals who had no prior or family history of somnambulism and had attention-deficit/hyperactivity disorder. The possible significance of this will also be discussed. Somnambulism is a common parasomnia that reflects an impairment in the normal mechanisms of arousal from sleep in which motor behaviors are activated without full consciousness. Motor behaviors are initiated during deep non-rapid eye movement or slow-wave sleep (stages 3-4), and may be limited to relatively simple manifestations, such as sitting up, fumbling with objects or bedclothes, or mumbling.     

Early abuse, psychiatric diagnoses and irritable bowel syndrome

In a population of 71 (57 female, 14 male) IBS patients seeking psychological treatment, we found expected levels of childhood sexual and physical abuse (57.7%) and expected levels of current Axis I psychiatric disorders (54.9%). Moreover, we found those who had been victims of early abuse had higher current Beck Depression Inventory scores. However, contrary to expectations, there were no significant associations between early abuse and current psychiatric disorder in this population, suggesting that those individuals with psychological distress are not exactly the same group with a history of abuse.     

To be or not to be: an exploration of ethnic identity development in context

This qualitative study focused on the intersection of personal and ethnic identities among forty African American, Puerto Rican, Dominican, and Chinese American high school students. The patterns in content indicated that for the Puerto Ricans, the intersection of their personal and social identities was a series of accommodations to a positive peer climate and a resistance to being Dominican. For the other ethnic groups, the intersection of their personal and social identities consisted of a process of resistance and accommodation to negative stereotypes projected on them by their peers and, for African Americans, themselves.     

The Medical Humanities and the Perils of Curricular Integration

The advent of integration as a feature of contemporary medical curricula can be seen as an advantage for the medical humanities in that it provides a clear implementation strategy for the inclusion of medical humanities content and/or perspectives, while also making its relevance to medical education more apparent. This paper discusses an example of integration of humanities content into a graduate medical course, raises questions about the desirability of an exclusively integrated approach, and argues for the value of retaining a discrete and coherent disciplinary presence for the medical humanities in medical curricula.     

Prediction of treatment outcome among patients with irritable bowel syndrome treated with group cognitive therapy

Using a sample of over 125 patients with irritable bowel syndrome (IBS) who were treated with cognitive therapy administered in small groups, we sought to predict end of treatment and 3-month follow-up improvement in two changes indices of gastrointestinal (GI) symptoms (Pain/Discomfort Index which assessed change in abdominal pain, abdominal tenderness and bloating and Bowel Regularity Index which assessed change in diarrhea and constipation). We also sought to predict scores on IBS specific quality of life (QOL) and overall level of psychological distress using the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI). Significant, but modest, levels of prediction were found for prediction of improvement in GI symptoms (4-15% of variance). Stronger significant prediction was obtained for the QOL and global psychological distress measure with R(2)'s ranging from 0.36 to 0.50. A wide variety of demographic, GI symptom, psychological status and psychiatric status variables entered the final prediction equations.     

Predictors of complicated grief

Abstract

This study examined whether process variables predict an outcome of complicated grief. A turbulent and prolonged grief was predicted to occur after the death of a spouse in subjects who had self-blame, used the deceased for an extension of self, had ambivalence toward the deceased, or overcontrolled emotional responses. Ninety subjects were examined at 6, 14, and 25 months after the loss via a self-report battery of process variables and a structured clinical interview designed to assess symptoms. Subjects with complicated grief were compared with those with normative grief. Predictions were supported only in tertiary data analyses; they were not supported well in the primary and secondary statistical analyses. The authors concluded that either self-reports of process variables are inadequate measures or the theory that led to these measures and predictions is in need of revision.     

Psychological Health From the Teens to the 80s: Multiple Developmental Trajectories

Data from the long-term Intergenerational Studies are used to explore men’s and women’s psychological health trajectories from early adolescence to late adulthood, as elucidated by Nagin’s (Group-based modeling of development. Harvard University Press, Cambridge, MA, 2005) finite mixture modeling method. Two separate measures of psychological health, one from the California Q-sort (CQS; Block in The Q-sort method in personality assessment and psychiatric research. Thomas, Springfield, IL, 1961) and one from the California Psychological Inventory (CPI; Gough and Bradley in CPI manual, 3rd edn. Consulting Psychologists Press, Palo Alto, CA, 1996) are used, with a maximum of six pooled points of data collection. Distinct subtypes of developmental trajectory are uncovered, including patterns of nearly life-long trajectories of stability, as well as trajectories of increasing psychological health. For both measures of psychological health, the most common path (53% for CQS data, and 46% for CPI data) is that of relatively high initial psychological health with a subsequent modest linear increase. Results from the two measures neither perfectly replicate nor completely contradict one another. Both indicate the existence of discrete subgroups of change, including stability of psychological health for some and significant increase for others.     

Interpersonal Style, Stress, and Depression: An Examination of Transactional and Diathesis-Stress Models

The present study examines a transactional, interpersonal model of depression in which stress generation (Hammen, 1991) in romantic relationships mediates the association between aspects of interpersonal style (i.e., attachment, dependency, and reassurance seeking) and depressive symptoms. It also examines an alternative, diathesis-stress model in which interpersonal style interacts with romantic stressors in predicting depressive symptoms. These models were tested in a sample of college women, both prospectively over a four-week period, as well as on a day-today basis using a daily diary methodology. Overall, there was strong evidence for a transactional, mediation model in which interpersonal style predicted romantic conflict stress, and in turn depressive symptoms. The alternative diathesis-stress model of depression was not supported. These results are interpreted in relation to previous research, and key limitations that should be addressed by future research are discussed.