Selective impairment of phonation: A case study

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.     

Developmental dyslexia and word retrieval deficits

Developmental dyslexics, selected on the basis of very slow naming rates on the Rapid Automatic Naming Tasks (RAN), were compared to normal readers on oral language, picture categorization, and reading tasks. Findings indicated that the dyslexics' word retrieval deficits were one symptom of a more generalized, however subtle, oral language deficit which involved both receptive and expressive oral language functioning. The dyslexics' word retrieval problem also seemed chiefly related to language processing and not to deficits in semantic memory as there were no significant differences between dyslexics and controls on a nonverbal semantic memory task (picture categorization). In naming and identifying printed words, the dyslexics appeared to rely considerably upon the "indirect" or "assembly-of-phonology" route; they were slower in naming irregularly spelled words compared to regularly spelled words and on a lexical decision task, the dyslexics were slower in making negative decisions for "pseudohomophones" (e.g., "braik") than for other matched nonwords. Results are discussed in terms of the logogen model with some consideration of a developmental model as well.     

Powers, causation, and modality

A complex theory concerning powers, natures, and causal necessity has emerged from the writings of P. H. Hare, E. H. Madden, and R. Harré. In the course of rebutting objections that other critics have raised to the power account of causation, I correct three of its genuine difficulties: its attempt to analyze power attributions in terms of conditional statements; its characterization of the relation between something's powers and its nature; and its doctrines concerning conceptual necessity. The resulting interpretation of causal modalities is then subsumed under a more general power account of modality, related at a number of points to considerations concerning powers, and further illustrating their philosophical importance.     

Memory and awareness in a patient with multiple personality disorder

We studied an individual with multiple personality disorder in whom each of several personalities claimed to have no direct awareness of the others and to be unable to consciously remember the experiences of other personalities. A broad selection of implicit and explicit memory tests was used to determine the extent to which one personality had access to knowledge acquired by another and the circumstances in which that knowledge would be expressed. The implicit assessment of memory was a necessary but not sufficient condition for demonstrating interpersonality access. The degree of compartmentalization of knowledge in this patient depended largely on whether the interpretation of presented information was likely to differ across personalities.     

Knowledge and beliefs regarding the consequences of cigarette smoking and their relationships to smoking status in a biracial sample

The purpose of this investigation was to evaluate carefully smoking-related knowledge and beliefs and their relationships to smoking status in a large, heterogeneous sample of smokers and nonsmokers in two settings: (a) a large, biracial southern city and (b) a small midwestern community. Participants were 611 (198 male, 413 female) adult respondents to a random-dialing telephone survey in Fargo, North Dakota (n = 200), and Memphis, Tennessee (n = 411). Each participant was given the Smoking Attitudes Survey, which assesses generalized health beliefs as well as health-related problems associated with smoking. Participants' knowledge of smoking-associated diseases (e.g., lung cancer) and of diseases not associated with smoking (e.g., kidney stones) was assessed. Stepwise regression analysis of composite knowledge scores revealed four independent predictors of the health consequences of smoking: education, race, smoking status, and income. Smokers, compared to nonsmokers, reported less knowledge related to the health consequences of smoking, were more likely to be male, were less concerned with the health consequences of smoking, and were more concerned about the health consequences of cholesterol. The best predictor of smokers who had never attempted cessation was their greater concern over weight control when compared to smokers with a history of smoking cessation attempts. The results are discussed in terms of smoking prevention and intervention efforts.     

Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.