Cerebral laterality and depression: differences in perceptual asymmetry among diagnostic subtypes

Examined the influence of diagnostic subtype of depression on perceptual asymmetry for dichotic listening and visual tachistoscopic tasks. A total of 65 unmedicated patients with major depressive disorders and 30 normal controls were tested on a verbal and nonverbal task in each modality. Patients diagnosed according to the DSM-III with melancholia had abnormal perceptual asymmetry for dichotic nonsense syllable and complex tone tasks. In contrast, patients having a nonmelancholic "atypical depression" (reactivity of mood with preserved pleasure capacity and associated features) did not differ from normal controls on these tasks, but had an increased incidence of left handedness. Bipolar depression (history of hypomania) differed from unipolar depression in showing abnormal perceptual asymmetry for a tachistoscopic dot enumeration task. Alterations of perceptual asymmetry in melancholia and bipolar depression were consistent with hypothesized right hemisphere dysfunction.     

Relations of sociotropic and autonomous personality characteristics to specific symptoms in depressed patients

A number of writers have suggested that two sets of personality characteristics are associated both with vulnerabilities to depression in response to different classes of events and with different clinical presentations of depression. The present study examined the relations between levels of sociotropic and autonomous personality characteristics and specific, theoretically derived clusters of symptoms in 80 unipolar depressed patients. As was predicted, sociotropy was related to the cluster of symptoms associated with the concept of anxious-reactive depression and was unrelated to the autonomous symptoms cluster. In contrast, the predicted relations of autonomous personality characteristics and symptoms were not found. These results support the idea that the symptom picture in depression may be related to personality characteristics, but they also suggest that the measurement of autonomy may require revision.     

Contributions of clinical neuropsychology to the study of schizophrenia

Clinical neuropsychological findings are examined with respect to competing hypotheses about localized neuropathology in schizophrenia. Two general models of structural and functional impairment are described. The first addresses deficits in cortical/subcortical processes concerned with arousal, attention, and higher cortical functions. The second addresses impairments in the balance of lateralized functions consistent with left hemisphere overactivation. Empirical data provide support for both models, and suggest that the explanatory power of these models may vary when they are applied to different subtypes of schizophrenia.     

Nonclinical panic in college students: an investigation of prevalence and symptomatology

This article presents data on the prevalence and symptomatology of panic attacks and panic disorder (PD) in a large nonclinical sample (n = 2,375) of college students. Results showed that approximately 12% of the sample had experienced at least one unexpected panic attack and that 2.36% met DSM-III-R criteria for panic disorder. Although there were no sex differences in overall panic attack prevalence, men reported significantly more panic-related worry than women, and women reported a higher panic frequency than men. Compared to subjects who met DSM-III-R criteria for PD, infrequent panickers presented with fewer panic symptoms, fewer panic episodes, less panic-related worry, lower anxiety sensitivity, and less panic-related avoidance. Moreover, compared with PD subjects, the infrequent panickers were much less likely to report fears of dying, going insane, and derealization during a panic attack. The findings provide preliminary support for the role of anxious apprehension as a psychological vulnerability factor in the pathogenesis of panic disorder.     

Family Functioning of Male Alcoholics and Their Female Partners during Periods of Drinking and Abstinence

Family functioning of 20 alcoholic male veterans and their female partners was assessed in relation to drinking (wet) and abstinent (dry) intervals. Repeated measures analyses performed on the McMaster Family Assessment Device (FAD) indicated that on all 7 scales of the FAD, alcoholics and their mates perceived family functioning to be better during dry than wet periods. In contrast to their alcoholic mates, female partners gave healthier ratings to all FAD scales except Roles in the dry condition and Affective Involvement in the wet condition. According to published cutoff scores for healthy and unhealthy family functioning, alcoholics as a group viewed their wet and dry family functioning as unhealthy, although the female group regarded the family's dry Problem Solving and Behavioral Control as healthy. These findings suggest that the family functioning of alcohol-involved couples is biphasic, oscillating between drinking and abstinent periods.     

A paradigm for construction of family therapy tasks

Typically, family therapy task interventions involve direct assignment of specific behaviors, which may or may not encourage client compliance. To enhance the clinician's probability of bringing about progress in treatment, this article broadens the parameters of task intervention to include (a) Direct versus Indirect, (b) Behavioral versus Nonbehavioral, and (c) Paradoxical versus Nonparadoxical dimension alternatives. The resulting 2 x 2 x 2 model, the Family Therapy Task Construction Paradigm, yields eight possible choices for end-of-the-session punctuation. Each option is linked to corresponding treatment contexts and illustrated with examples from productive case vignettes.     

The "psychosomatic family" model: an empirical and theoretical analysis

Evolution of the Family Systems Paradigm has been constrained by the dichotomy between theory building and empirical research. This article integrates these two domains by presenting a theoretical analysis of the "psychosomatic family" model as it informs and is informed by an empirical research project. Forty families of children with Crohn's disease (CD), ulcerative colitis (UC), and functional recurrent abdominal pain syndrome (RAP) were rated during standard, videotaped family interaction tasks, lunch, and interview. Laboratory scores of disease activity were associated with triangulation, marital dysfunction, and total "psychosomatic family" scores. Disease activity was not significantly correlated with enmeshment, overprotection, rigidity, conflict avoidance, or poor conflict resolution. Thus, the marital/triangulation and enmeshment/overprotection/conflict clusters may be subcomplexes of the "psychosomatic family" complex. CD, UC, and RAP groups differed in the relations among particular family patterns and disease activity. A heuristic family-psycho-somatic model is presented to facilitate future research.     

Diagnosis of major depression by self-report

The Symptom Checklist-90 (SCL-90), Millon Clinical Multiaxial Inventory (MCMI), and Minnesota Multiphasic Personality Inventory (MMPI) test profiles of inpatients and outpatients with DSM-III major depression (n = 48) were contrasted with the test profiles of a control group of patients with diverse psychiatric disorders (n = 68). In addition, the diagnostic efficiency of the relevant depression subscales for the diagnosis of major depression were examined. The results indicated that the three self-report tests may be used to diagnose DSM-III major depression, and that the depressed patients had characteristic test profiles.     

Standardizing the administration of the Profile of Mood States (POMS): development of alternative word lists

Although standard administration procedures are essential for valid inference making, current Profile and Mood States (POMS; McNair, Lorr, & Droppleman, 1971) protocol forces each examiner, when asked for assistance, to provide subjects extemporaneously with a word or phase that is: (a) synonymous with the original item, (b) located nowhere else on the instrument, and (c) more meaningful to the subject than the original item. The purpose of this article is to describe an empirically based extension of current POMS protocol designed to augment uniformity in administration procedures by providing examiners with a standardized list of alternatives to be referred to when questions concerning the meaning of POMS items arise. A multiphase survey procedure was employed to generate and refine alternative items. A series of alpha (internal consistency) reliabilities, calculated for the POMS subscales after each alternative was substituted, revealed little change in subscale homogeneity resulting from the substitution of the alternatives.