Münchhausen by Proxy Syndrome in Clinical Child Neuropsychology: A Case Presenting With Neuropsychological Symptoms

Münchhausen by proxy syndrome (MBPS) is a rare but dramatic variant of child abuse. In MBPS adults, mostly the mother, invent, manipulate, or produce the child's illness, and as a consequence the child has to undergo numerous diagnostic or treatment procedures. Typically, valid information about the etiology of the child's illness is withheld by the parents, and reversible symptoms vanish, when the child and the responsible adults are separated. Although valid statistical data about the epidemiology of MBPS are not available, MBPS should be considered more often than normally recognized. Neurological and neuropsychological presentations including developmental delays and learning problems appear to be common among MBPS cases so that clinical child neuropsychologists should be aware of this problem and consider MBPS at least in some of the mysterious cases that come to their attention. The present study describes a case of MBPS in which neurological and neuropsychological symptoms predominate. It presents a MBPS variant that is characterized by developmental delays and learning problems induced by unnecessary isolation at home, hospitalization, and treatment procedures. In the present case MBPS was at first suspected following neuropsychological assessment, since some of the main features of non-authenticity of symptom presentation gave cause for suspecting deceptive behavior on the mother's (and possibly also on the maternal grandmother's) side.     

The elusive goal of informed consent by adolescents

While parents have traditionally provided proxy consent for minors to participate in research, this has proven inadequate for adolescents who are mentally and emotionally capable of making their own decisions. Research has proven that even young children, and certainly most adolescents, are developmentally prepared to make such decisions for themselves. The author challenges the assumption that both consent and assent are static concepts, and proposes that a sliding scale of competence be created to ascertain the adolescent's comprehension of the proposed research by shifting the burden of proof to those who believe a particular adolescent is unable to provide informed consent.     

Five Elements of Normative Ethics - A General Theory of Normative Individualism

The article tries to inquire a third way in normative ethics between consequentialism or utilitarianism and deontology or Kantianism. To find such a third way in normative ethics, one has to analyze the elements of these classical theories and to look if they are justified. In this article it is argued that an adequate normative ethics has to contain the following five elements: (1) normative individualism, i. e., the view that in the last instance moral norms and values can only be justified by reference to the individuals concerned, as its basis; (2) consideration of the individuals’ concerns and interests—aims, desires, needs, strivings—insofar as they have a justificatory function; (3) a pluralism of references of these concerns and hence of moral norms and values to all possible elements of actions; (4) the necessity of a principle of aggregation and weighing with regard to these concerns; (5) finally, as a central principle of aggregation and weighing, the principle of relative reference to self and others, operating as a generalizing meta-principle that guides the application of concrete principles and decisions.     

Differential neuronal responses to the self and others in the extrastriate body area and the fusiform body area

The extrastriate body area (EBA) and the fusiform body area (FBA) are selectively activated by viewing human bodies. However, the role of these functionally defined brain areas in self-other discrimination is still unresolved. Thirty-one females were presented with 16 pictures of their own body and another body in a bikini and with scrambled images while fMRI was performed. Moreover, standardized stimulus material was used in order to localize the EBA and FBA. Region-of-interest analysis showed an enhanced BOLD response to the self-images relative to the non-self-images in the right EBA and FBA. The right EBA and FBA are activated differently by viewing oneself and others and might thus play a role in visual self-other discrimination.     

Derivation of the antiphase-boundary energy of L1 2 long-range-ordered precipitates from measurements of the minimum size of stable dislocation loops

In an alloy that is strengthened by long-range-ordered particles, a matrix dislocation generates an antiphase boundary (APB) when it cuts through such a particle. The specific energy n APB of this APB has been measured for two fcc alloys with spherical coherent L12 ordered particles: an Al-7.5at.%Li-alloy and the commercial Ni-base superalloy Nimonic PE16. Peak-aged specimens have been deformed and Orowan loops searched for using transmission electron microscopy. n APB has been derived from the radii of the smallest dislocation loops which have been left behind around particles. Such an approach had been used previously, for example, by Raynor and Silcock and by Nembach et al . Here an improved evaluation method has been applied; it is based on the results of computer simulations of the equilibrium configurations of dislocation loops.     

Die Wirkung von traumatischem Stress auf biopsychische Selbstorganisationsprozesse

Social frameworks have influenced the understanding of trauma-reactive psychic disorders during the course of the past two centuries.The 20th century has further shaped this understanding by the various concepts established by the different therapeutic schools.The incorporation of scientific results, as well as the theory of complex dynamic systems particularly that of synergetics supply now abundant impulses stimulating the discussion of posttraumatic stress disorders on a psychodynamic, neurophysiological, and systemspecific basis, thereby leaving those schools behind.Comparing synergetic models with the current state of neuroscientific research of post traumatic stress disease (PTSD) gives surprising insights of the dynamics of this disorder,and the resulting therapeutic principles.Specific therapeutic approaches, with the two phases of stabilisation and of trauma processing can be derived from such functional principles of neuronal networks.     

Attention,spatial representation,and visual neglect: simulating emergent attention and spatial memory in the selective attention for identification model (SAIM)

The selective attention for identification model (SAIM) is presented. This uses a spatial window to select visual information for recognition, binding parts to objects and generating translation-invariant recognition. The model provides a qualitative account of both normal and disordered attention. Simulations of normal attention demonstrate 2-object costs and effects of object familiarity on selection, global precedence, spatial cueing, and inhibition of return. When lesioned, SAIM demonstrated either view- or object-centered neglect or spatial extinction, depending on the type and extent of lesion. The model provides a framework to unify (a) object- and space-based theories of normal selection, (b) dissociations within the syndrome of unilateral neglect, and (c) attentional and representational accounts of neglect.     

Attention and spatial resolution: a theoretical and experimental study of visual search in hierarchical patterns

Our aim has been to study visual search in hierarchical patterns through a computational neuroscience perspective. In this way we were able to analyse the relationship between the global precedence effect and attention. The theoretical part of our investigations extended a model built upon the biased-competition hypothesis. An important feature of this extension is that different spatial frequencies are processed with different time constants. Simulations with this model resulted in specific predictions that were confirmed with a novel visual-search experiment utilising hierarchical patterns. Both experiment and simulations suggest that the global-precedence effect prevails under the condition of visual search.