Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Are there interactions among dysfunctional beliefs in obsessive compulsive disorder?

Contemporary cognitive models of obsessive-compulsive disorder emphasize the importance of various types of dysfunctional beliefs, such as beliefs about inflated responsibility, perfectionism and the importance of controlling one's thoughts. These beliefs have been conceptualized as main effects, each influencing obsessive-compulsive symptoms independent of the contributions of other beliefs. It is not known whether beliefs interact with one another in their influence on obsessive-compulsive symptoms. To investigate this issue, data from 248 obsessive-compulsive disorder patients were analyzed. Dependent variables were the factor scores on the 4 Padua Inventory subscales. Predictor variables were the factor scores from the 3 factors (inflated responsibility, perfectionism and controlling one's thoughts) of the Obsessive Beliefs Questionnaire and their 2- and 3-way interactions. Regression analyses revealed significant main effects; in almost all analyses one or more of inflated responsibility, perfectionism, and controlling one's thoughts factors predicted scores on the Padua factors even after controlling for general distress. There was no evidence that beliefs interact in their effects on obsessive-compulsive symptoms, thereby providing a relatively unusual instance in which a simpler explanation (main effects only) is just as powerful as a more complex model.     

Cognitive compensations for blindness in children: an investigation using odour naming

Historically, blindness has been associated with compensation for the loss of vision by the other senses. However, research to date has focused on perceptual compensations, largely ignoring possible cognitive compensations. We explored the notion that cognitive skills of blind children may facilitate performance in apparently perceptual tasks, by investigating the cognitive factors related to naming a familiar odour. Eighty-three children participated in olfactory and cognitive tasks (thirty-two early-blind, five late-blind, fourteen low-vision, and thirty-two sighted). In the olfactory tasks, the early-blind children performed significantly better than the sighted children on the odour-naming task but not on the odour-sensitivity task. From the cognitive tasks, scores on a nonvisualisable word-pairs task and a sound-word-pairs task were significantly higher for early-blind children and were highly correlated with odour-naming score. The early-blind children outperformed the sighted controls on a task of directed attention. The groups did not differ on memory for a story or for visualisable word pairs. The results suggest that blind children enjoy an advantage in tasks that assess nonvisual memory for paired associates and directed attention, and that superiority on these tasks facilitates performance in the odour-naming task. Other data suggest that sighted children rely on visualisation as a strategy to aid their performance on the cognitive tasks, and are disadvantaged when these strategies cannot be utilised.     

Linguistic focus and good-enough representations: An application of the change-detection paradigm

A number of lines of study suggest that word meanings are not always fully exploited in comprehension. In two experiments, we used a text-change paradigm to study depth of semantic processing during reading. Participants were instructed to detect words that changed across two consecutive presentations of short texts. The results suggest that the full details of word meanings are not always incorporated into the interpretation and that the degree of semantic detail in the representation is a function of linguistic focus. The results provide evidence for the idea that representations are only good enough for the purpose at hand (Ferreira, Bailey, & Ferraro, 2002).     

Effects of repetition and configural changes on the development of face recognition processes

We investigated the effect of repetition on recognition of upright, inverted and contrast-reversed target faces in children from 8 to 15 years when engaged in a learning phase/test phase paradigm with target and distractor faces. Early (P1, N170) and late ERP components were analysed Children across age groups performed equally well, and were better at recognizing upright faces. However, teenagers and adults were equally accurate for all three face types. The neurophysiological responses to upright, inverted and negative faces matured until adulthood and showed different effects at different ages. P1 and N170 components were affected by face type at all ages, suggesting early configural disruption on encoding processes regardless of age. Frontal ERPs reflected the difficulty of processing these stimuli. Distinct repetition effects were seen at frontal, temporal frontal and parietal sites, suggesting differential involvement of these brain regions underlying working memory and recognition processes. Thus, a learning phase was sufficient (a) for 8-year-olds to perform as accurately as 15-year-olds and (b) to eliminate face type effects in teenagers and adults, but not in younger children.     

Face inversion and contrast-reversal effects across development: in contrast to the expertise theory

To determine the role of configural changes on the development of face encoding and memory, we investigated face recognition in an n-back repetition task with upright, inverted and contrast-reversed unfamiliar faces in adults and children (8-16 years). Repetitions occurred immediately (0-lag) or after one intervening face (1-lag). Face recognition continued to develop beyond 14-16 years, as shown with hit rates, d' scores and reaction times that all improved with age. Inversion and contrast-reversal effects were found in all subjects but were not more pronounced with increasing age, suggesting no increased reliance on configural processing and thus arguing against the expertise theory of Diamond and Carey (1986). Recognition improved with age in upright but also in inverted and contrast-reversed faces, suggesting a quantitative rather than a qualitative developmental change in face processing. For all age groups, performances decreased and reaction times increased from 0- to 1-lag conditions similarly, suggesting a similar memory component involved in adults' and children's processing. These data suggest gradual quantitative improvements in face processing with age, mainly due to increasing working memory processing capacity.     

Psychological sequelae of remote exposure to the September 11th terrorist attacks in Canadians with and without panic

The purpose of the present investigation was to examine the psychological impact of remote exposure to the events and aftermath of the terrorist attacks in the USA on September 11th, 2001, and to assess what differences, if any, exist between individuals classified with probable panic disorder and those without. Telephone interviews were conducted with 122 residents of the capital city of the Canadian prairie province of Saskatchewan in spring 2002 in order to gather information regarding current mood, fears and avoidance behaviours as well as current post-traumatic stress disorder symptoms specific to September 11th. Consistent with previous findings and despite the remote nature of exposure, results indicated that the psychological well-being and behaviour of participants with probable panic disorder was more adversely affected by the events and aftermath of September 11th than those without panic disorder. These results suggest that remote viewing of traumatic events can have a significant and lingering impact on psychological well-being and behaviour and that these effects are more pronounced in those with panic disorder. Implications of the findings and future research directions are discussed.     

Laterality effects in perceived spatial location of hallucination-like voices

Aydin and colleagues reported a reversal of physiological 'right-ear advantage' in a group of right-handed patients with schizophrenia, using an auditory acuity test. In schizophrenia, auditory hallucinations may appear to be spatially located inside or outside the patient's head. Here we show, using virtual acoustic space techniques, that normal right-handed subjects have a right-ear advantage for correctly locating the 'source' of hallucination-like voices as from either inside or outside the head. We propose a model for understanding lateralised, external hallucinations in schizophrenia based upon reversal of normal cortical asymmetry for auditory spatial processing.     

Genetic and Environmental Influences on Psychopathy Trait Dimensions in a Community Sample of Male Twins

Psychopathy appears to be comprised of two broad dimensions: impulsivity/antisocial behavior and interpersonal detachment/callousness. This study examined the extent to which variance in these 2 psychopathy trait dimensions was associated with common or unique genetic, shared, and nonshared environmental factors in two independent samples of reared together 16–18-year-old male twins. One sample included 142 monozygotic (MZ) and 70 dizygotic (DZ) pairs; the other sample included 128 MZ and 58 DZ pairs. Boys completed the Minnesota Temperament Inventory (MTI), a 19-item measure that contains separate subscales: Antisocial and Detachment. Variance in the Antisocial and Detachment scales was associated with additive genetic factors and neither scale was associated with shared environmental factors. As expected, the bivariate biometric analysis suggested genetic influence on the covariance of the scales. The results are consistent with theoretical models of psychopathy that posit some independence in the etiology of the two major trait dimensions of psychopathy.