Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation

Because few prospective studies have examined predictors of body dissatisfaction--an established risk factor for eating disorders--the authors tested whether a set of sociocultural, biological, interpersonal, and affective factors predicted increases in body dissatisfaction using longitudinal data from adolescent girls (N = 496). Elevated adiposity, perceived pressure to be thin, thin-ideal internalization, and social support deficits predicted increases in body dissatisfaction, but early menarche, weight-related teasing, and depression did not. There was evidence of 2 distinct pathways to body dissatisfaction--1 involving pressure to be thin and 1 involving adiposity. Results support the contention that certain sociocultural, biological, and interpersonal factors increase the risk for body dissatisfaction, but suggest that other accepted risk factors are not related to this outcome.     

Conditions of visual verbal extinction: does the ipsilesional stimulus have to be identified?

Six left-neglect patients were presented with four-letter words in the left and/or right hemifield, in different contextual conditions: unilateral, bilateral-x in which one word appears on one side and a string of "x" appears on the other side (the side of "x' was not predictable), and bilateral-word (presentation of one word in each hemifield). In Experiment 1, left extinction occurred even if the right stimulus was an easily discriminable string of "x." Experiment 2 showed that increasing the size of the left stimuli reduced extinction when a string of "x" was presented on the right hemifield. However, extinction was stronger with bilateral-word presentation. These results indicate the presence of an early component in the extinction phenomenon, i.e., a "magnetic" attraction toward the ipsilesional hemifield, but are also in favor of some additional deficit, at a later stage of information processing.     

Screening for apraxia: a short assessment for stroke patients

Apraxia is a disorder that involves impaired ability to execute previously learned movements that cannot be attributed to basic sensory or motor disturbances. A thorough assessment of apraxia typically entails both pantomiming and imitation of transitive (tool-related), intransitive (communication-related), and meaningless gestures, presented in an array of different, process-dependent sensory conditions. Precise and detailed assessment tools are often time-consuming and a shorter screening tool may be desirable for efficient surveillance of this disorder in stroke patients. In the present study, stroke patients (N = 37) were compared to healthy controls (N = 30) in their production of commonly used transitive and intransitive gestures. Five gestures (knife, flipper, tweezers, okay sign, cab hailing) were consistently performed with poorer accuracy in stroke patients when compared to healthy controls. The combination of gestures that best captured apraxic performance was statistically determined based on Z-score data. Results provide a shortened and sensitive method of detecting apraxia in stroke patients.     

On the ability of children with developmental coordination disorder (DCD) to inhibit response initiation: the simon effect

The ability of children with developmental coordination disorder (DCD) to inhibit the initiation of an incorrect manual response urge was examined using a typical Simon task. While the size of the Simon effect was the same for both DCD (N = 20) and Control (N = 20) groups of children, showing no difference with respect to the time needed to complete the inhibition an unwanted response, children with DCD produced significantly more errors of the type which reflected a reduced ability to successfully effect the inhibition operation when it was required. This result is consistent with some earlier findings pointing to an inhibitory deficit for children with DCD (Wilson & Maruff, 1999).     

Cognitive-behavioral treatment of high anger drivers

Relaxation and cognitive-relaxation interventions were compared to a no treatment control in the treatment of high anger drivers. The cognitive portion of the cognitive-relaxation condition adapted the style of Beck's cognitive therapy, particularly use of Socratic questions and behavioral experiments and tryouts, to driving anger reduction. Both interventions lowered indices of driving anger and hostile and aggressive forms of expressing driving anger and increased adaptive/constructive ways of expressing driving anger. The cognitive-relaxation intervention also lowered the frequency of risky behavior. Both interventions lowered trait anger as well. Limitations and implications for treatment and research were discussed.     

Towards an understanding of unique and shared pathways in the psychopathophysiology of ADHD

Most attention deficit hyperactivity disorder (ADHD) research has compared cases with unaffected controls. This has led to many associations, but uncertainties about their specificity to ADHD in contrast with other disorders. We present a selective review of research, comparing ADHD with other disorders in neuropsychological, neurobiological and genetic correlates. So far, a specific pathophysiological pathway has not been identified. ADHD is probably not specifically associated with executive function deficits. It is possible, but not yet established, that ADHD symptoms may be more specifically associated with motivational abnormalities, motor organization and time perception. Recent findings indicating common genetic liabilities of ADHD and other conditions raise questions about diagnostic boundaries. In future research, the delineation of the pathophysiological mechanisms of ADHD needs to match cognitive, imaging and genetic techniques to the challenge of defining more homogenous clinical groups; multi-site collaborative projects are needed.     

The impact of comorbidity on the management of pathological gambling

A 30-year-old woman with severe pathological gambling and cyclothymia presented to our program with no previous history of pharmacologic or psychotherapeutic treatment. Pathological gambling is an impulse -control disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) in which comorbidity is common, particularly with substance abuse, obsessive-compulsive disorder and mood disorders. As described in this case, pathological gamblers with bipolar comorbidity may be effectively treated with mood stabilizers such as lithium. After receiving 10 weeks of lithium treatment, the patient showed improvement in both gambling behavior and affective instability. The identification of specific subtypes among patients with pathological gambling may be relevant to the choice of pharmacologic treatment.     

Pediatric resuscitation: questioning DNAR legitimacy and offering an alternative decision-making model

The views expressed in this paper are those of the author and do not necessarily represent those of the American Medical Association.