Is anorexia nervosa a neuropsychological disease?

Evidence for central nervous system, and more particularly cortical, etiology of anorexia nervosa is reviewed. Topics covered are neuropsychiatric comorbidity, inheritance patterns, the neurobiology of body-image disturbance and of the eating function, perinatal and alcoholic insult to the brain, neurochemical and neuroelectric disturbance, anatomic and metabolic brain imaging, and neuropsychological impairment. It is concluded that there is indeed an important neuropsychological etiological dimension to anorexia nervosa. The profile most frequently associated with anorexia nervosa is right posterior hypometabolism, followed by right anterior hypermetabolism, both associated with right-sided abnormal electroencephalogram spiking. It is also proposed that bulimia consists of a positive neurological subtype and that restricting anorexia represents a negative neurological subtype. Priorities for further research into anorexia nervosa are specified to include twin adoption studies, brain electrical topography studies, postmortem histological studies, and experimentally inspired neuropsychological studies.     

Are Reaching Movements Planned to be Straight and Invariant in the Extrinsic Space? Kinematic Comparison Between Compliant and Unconstrained Motions

Two main questions were addressed in the present study. First, does the existence of kinematic regularities in the extrinsic space represent a general rule? Second, can the existence of extrinsic regularities be related to specific experimental situations implying, for instance, the generation of compliant motion (i.e. a motion constrained by external contact)? To address these two questions we studied the spatio-temporal characteristics of unconstrained and compliant movements. Five major differences were observed between these two types of movement: (1) the movement latency and movement duration were significantly longer in the compliant than in the unconstrained condition; (2) whereas the hand path was curved and variable according to movement direction for the unconstrained movements, it was straight and invariant for the compliant movements; (3) whereas the movement end-point distribution was roughly circular for the unconstrained movements, it was consistently elongated and typically oriented in the movement direction for the compliant movements; (4) whereas constant errors varied as a function of target eccentricity for the unconstrained movements, they were independent of this factor for the compliant movements; (5) the instruction to move the final effector along a straight line path influenced the characteristics of the unconstrained movements but not the characteristics of the compliant movements. When considered together, the previous observations suggest that compliant and unconstrained movements involve different planning strategies. Our data support the hypothesis that unconstrained motions, unlike compliant motions, are not programmed to follow a straight line path in the extrinsic space. This observation provides a theoretical frame of reference within which some apparently contradictory results reported in the movement generation literature may be explained.     

Must phenomenology remain Cartesian?

Husserl saw the Cartesian critique of scepticism as one of the eternal merits of Descartes?? philosophy. In doing so, he accepted the legitimacy of the very idea of a universal doubt, and sought to present as an alternative to it a renewed, specifically phenomenological concept of self-evidence, making it possible to obtain an unshakable foundation for the edifice of knowledge. This acceptance of the skeptical problem underlies his entire conceptual framework, both before and after the transcendental turn, and especially the immanence/transcendence distinction, i.e., the very basis of intentionality. In taking as its starting point an analysis of perception, the article puts forth a certain number of phenomenological arguments in order to put into question the validity of the skeptical problem and, therefore, of the Husserlian conceptual framework; it defends, in the first place, a disjunctive conception of perception and, in the second place, a holism of experience.     

Group CBT for early psychosis--are there still benefits one year later?

Our team recently conducted a randomized controlled trial comparing group cognitive behavior therapy for psychosis (CBTp) to group social skills training for symptom management and a wait-list control group, for early psychosis. The results at post-therapy and six months provided considerable empirical support for the efficacy of the group CBTp. The results of the one-year follow-up are described here. Given the high attrition rates, mostly in the comparison and control conditions, imputations were not possible, so that only the results of those having completed more than 50% of the group CBTp are presented. Significant improvements at 12 months were found for social support and insight. Negative symptoms remained low, whereas positive symptoms went back to pre-therapy levels. Challenges regarding attrition with this clientele are discussed.     

What Does the Alliance Predict in Group Interventions for Early Psychosis?

The therapeutic alliance is considered an essential component of any clinical or psychological intervention. The therapeutic alliance can however change over time, and therefore it is relevant to determine if the alliance and its variations are related to clinical outcomes. The present study had three objectives: (1) determine the impact of the alliance measured by the client and the therapist, on clinical and psychosocial outcomes of individuals with early psychosis receiving group interventions; (2) measure the concordance between the client and the therapists’ ratings of the alliance; and (3) determine the best predictor of the client’s alliance in our sample. A total of 36 individuals with early psychosis who participated in group interventions for symptom management answered the WAI three times, and so did the group therapists. Outcomes included measures of insight, symptoms (total, positive and negative), and self-esteem. Attendance and group participation were also measured. Results suggest that the overall client’s alliance predicted total symptoms and self-esteem at post-therapy, whereas both clients’ and therapists’ ratings predicted group attendance and participation. Greater variations in the alliance overtime for the clients were somewhat linked to worse negative symptoms at post-therapy. Alliance ratings were generally high and fairly concordant between therapists and clients. Only the baseline measure of capacity for attachment, predicted the client’s overall alliance scores. Clinical implications are discussed.