Reduced activation of left orbitofrontal cortex precedes blocked vocalization: A magnetoencephalographic study

While stuttering is known to be characterized by anomalous brain activations during speech, very little data is available describing brain activations during stuttering. To our knowledge there are no reports describing brain activations that precede blocking. In this case report we present magnetoencephalographic data from a person who stutters who had significant instances of blocking whilst performing a vowel production task. This unique data set has allowed us to compare the brain activations leading up to a block with those leading up to successful production. Surprisingly, the results are very consistent with data comparing fluent production in stutterers to controls. We show here that preceding a block there is significantly less activation of the left orbitofrontal and inferiorfrontal cortices. Furthermore, there is significant extra activation in the right orbitofrontal and inferiorfrontal cortices, and the sensorimotor and auditory areas bilaterally. This data adds weight to the argument forwarded by Kell et al. (2009) that the best functional sign of optimal repair in stutterering is activation of the left BA 47/12 in the orbitofrontal cortex.Educational objectives: At the end of this activity the reader will be able to (a) identify brain regions associated with blocked vocalization, (b) discuss the functions of the orbitofrontal and inferior frontal cortices in regard to speech production and (c) describe the usefulness and limitations of magnetoencephalography (MEG) in stuttering research.     

Genetic Disorders of Intellectual Disability: Expanding our Concepts of Phenotypes and of Family Outcomes

Over the past two decades, great strides have been made in our understandings of how genetic conditions influence behavior and how such so-called “behavioral phenotypes” influence parent and family stress and coping. In this paper, we call for expansions in two directions. First, as a field we need to go beyond behavior in our concepts of phenotypes, to also include the many medical, physical, and other “non-behavioral” phenotypes that influence children’s everyday lives. Second, in examining how etiology-related phenotypes affect others, we need to go beyond the outcome of parental stress. In this regard, we focus on parental health, well-being, and various life choices, as well as how parenting children with specific genetic disorders can often lead to positive perceptions and outcomes. We end by discussing remaining research issues and how these two expansions relate to clinical practice.     

Morphological processing during visual word recognition in developing readers: evidence from masked priming

Masked priming studies with adult readers have provided evidence for a form-based morpho-orthographic segmentation mechanism that "blindly" decomposes any word with the appearance of morphological complexity. The present studies investigated whether evidence for structural morphological decomposition can be obtained with developing readers. We used a masked primed lexical decision design first adopted by Rastle, Davis, and New (2004), comparing truly suffixed (golden-GOLD) and pseudosuffixed (mother-MOTH) prime-target pairs with nonsuffixed controls (spinach-SPIN). Experiment 1 tested adult readers, showing that priming from both pseudo- and truly suffixed primes could be obtained using our own set of high-frequency word materials. Experiment 2 assessed a group of Year 3 and Year 5 children, but priming only occurred when prime and target shared a true morphological relationship, and not when the relationship was pseudomorphological. This pattern of results indicates that morpho-orthographic decomposition mechanisms do not become automatized until a relatively late stage in reading development.     

Body Shape Questionnaire: Psychometric properties of the short version (BSQ-8C) and norms from the general Swedish population

There is a need for brief, sensitive, and reliable instruments for contextual assessment of body dissatisfaction. Suitable selection and optimal use of psychological assessment instruments requires appropriate psychometric as well as normative data. Two studies were conducted to investigate the psychometric properties and collect general population norms for a short, eight item version of the Body Shape Questionnaire (BSQ-8C). In the first study, a sample of undergraduate students (N = 182) was recruited to investigate the psychometric properties of the BSQ-8C, while in the second study a sample from the general population of Swedish women aged 18–30 years (N = 747) was used to collect norms. The test–retest reliability, internal consistency, and convergent validity for BSQ-8C were high. Given the questionnaire's briefness and good psychometric properties, particularly when used in conjunction with norms, the BSQ-8C is considered a valuable instrument for measuring body shape dissatisfaction among young adult women.     

The burden of disease among adolescents with personality pathology: quality of life and costs

In adults, personality disorders are associated with a low quality of life and high societal costs. To explore whether these findings also apply to adolescents, 131 adolescent patients were recruited from a mental health care institute in The Netherlands. Axis I and Axis II disorders were diagnosed using semi-structured interviews. The EuroQol EQ-5D was used to measure quality of life and costs were measured by the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. The mean EQ-5D index value was 0.55. The mean direct medical cost in the year prior to treatment was €14,032 per patient. The co-occurrence of Axis I and Axis II disorders was a significant predictor of a low quality of life. Direct medical costs were higher for the depressive personality disorder. This study shows that the burden of disease among adolescents with personality pathology is high. This high burden provides evidence to suggest that further research and development of (cost-)effective treatment strategies for this population may be worthwhile.     

Kasuistik eines Patienten mit Morbus Parkinson,der häufig wegen Schwindels stürzt

Reported is a case of a 73-year-old patient suffering from Parkinson’s disease, coronary artery disease with stable angina pectoris, polyneuoropathie NNB and untreated diabetes mellitus. For over a year, the patient reports experiencing dizziness which leads to falls. Presented is a case report in which the typical neurological cardinal symptoms have nothing to do with the neurological underlying illness. Without interdisciplinary cooperation no success can be achieved in these multimorbid patients.     

Image of God and personality pathology: An exploratory study among psychiatric patients

The associations between personality pathology according to DSM-IV, symptomatology and God image were examined among a group of 46 psychiatric patients. Features of personality disorders were assessed using the 'Questionnaire to Assess Personality Pathology', a self-report screener. God image was measured by means of the 'Questionnaire God Image'. Symptomatology was assesed by means of the SCL-90. The more personality pathology present, the more negative the image of God. The negative image of God appeared to be associated with personality pathology, in particular with pathology from the DSM-IV A- and C-cluster, even after controlling for the influence of symptomatology, suggesting that the association between symptomatology and the God image is mediated by personality pathology. When symptoms of the A-cluster are present God is experienced as detached and passive. When C-cluster symptoms prevail, God is experienced as a harsh judge. Results are discussed both from a psychodynamic object-relational as well as from a cognitive schema focused perspective.     

The association between personality,attachment, psychological distress,church denomination and the god concept among a non-clinical sample

The association between personality, attachment, psychological distress, church denomination and the God concept was studied among a sample of 208 subjects from the normal population. Subjects were Christians, members of an Orthodox reformed church or the Pentecostal church. Negative feelings towards God were associated with a high level of harm avoidance, insecure attachment and a high level of psychological distress. Psychological distress mediated the association between personality and attachment variables and negative feelings towards God. Psychological distress and church denomination were the only two independent predictors of negative feelings towards God. Moreover, results showed that the Orthodox reformed church members hold a more negative concept of God than the Pentecostal church members do. Orthodox reformed church members see God in particular as a punitive judge, independent of personality, attachment and psychological distress, suggesting a large influence of religious culture on this particular type of God concept. Results are discussed from a psychotherapeutic point of view. Finally, several ethical issues regarding psychotherapy with religious clients are addressed.     

‘Any room won’t do.’ Clinical psychologists’ understanding of the consulting room. An interview study

In the social sciences, there is increasing interest in spatial practices and the meaning of places. The meaning of the psychotherapeutic room and its boundaries has traditionally been underlined in psychodynamic practice. In this study we investigated how clinical psychologists, working from different perspectives and with varying interventions and populations understand and use the consulting room. Five clinical psychologists were interviewed about how they perceive and use consulting rooms. The interviews were analysed using Interpretative Phenomenological Analysis. The participants understood the consulting room as a logistic unit but also as a welcoming place for relational encounters and sensed that spatial stability was important for their capacity to be fully attentive to their clients. Moreover, technological booking systems could hinder clinical work. The results were understood with respect to Winnicott’s theories of transitional space and holding. In sum, the importance of the room does not seem to be of concern exclusively to psychodynamic psychologists. On the contrary, it seems as if psychologists working with varying interventions and from different perspectives emphasise stable and personal consulting rooms that permit them to adapt to the needs of the clients, be attentive, and avoid disturbances.     

State-dependent changes of prefrontal–posterior coupling in the context of affective processing: Susceptibility to humor

The aim of the present study was to examine whether interindividual differences in the coupling or decoupling of prefrontal and posterior cortices during the exposure to social–emotional information may predict an individual’s positive emotional responsiveness. Susceptibility to humor was assessed in a behavioral paradigm several weeks after the EEG recordings. State-dependent changes of prefrontal–posterior EEG beta coherence were recorded during stimulation with other people’s auditory expressions of cheerfulness and sadness. Greater decreases of coherence during the stimulation with positive affect expressions prospectively predicted greater positive emotional responsiveness, indicated by higher amusement ratings in response to cartoons and higher scores in a questionnaire measure of exhilarability. Greater increases of coherence during the stimulation with negative affect expressions did not predict perceived funniness but were related to shorter response latencies to the amusement ratings. The results further support the notion that a more loose prefrontal–posterior coupling may be related to loosening of control of the prefrontal cortex over incoming emotional information and, thus, to a propensity to deeper emotional involvement and a greater impact of perceptual input, whereas increased prefrontal–posterior coupling may be related to strong control and the propensity to protect oneself from becoming emotionally affected.