Working towards a new psychiatry - neuroscience, technology and the DSM-5

This Editorial introduces the thematic series on 'Toward a New Psychiatry: Philosophical and Ethical Issues in Classification, Diagnosis and Care' .     

The Determinants of Subjective Economic Well-being: An Analysis on Italian-Silc Data

Using Italian data on Income and living conditions for the year 2005, the paper investigates the main determinants of households’ subjective economic well-being by means of a Partial Proportional Ordered Logit Model. According to a joint subjective and objective perspective of analysis, we use as dependent variable the perceived ability of households to make ends meet. Whereas, we use as explanatory variables some objective aspects of living conditions relating to housing, financial equilibrium, possession of durables and quality of residence place and some socio-demographic characteristics. The empirical results show that the financial strain is the most relevant dimension of living conditions influencing the subjective economic well-being, but its effect is attenuated depending on the level of education and the tenure status of accommodation. Actually, when the highest levels of education are coupled with the status of self-employee and house-owner households have more chances to reach a higher probability to be economically satisfied. The insights coming out from the results may call for different policy measures depending on the degree of well-being and the characteristics of households. In particular, more efficient policies would be oriented to sustain the households’ income, to encourage to buy a house and to allow young people to get the highest levels of education.     

The neuropsychological correlates of cognitive insight in healthy participants

Cognitive insight is the ability to monitor and correct one's own erroneous convictions. The Beck Cognitive Insight Scale (BCIS) assesses two sub‐dimensions of cognitive insight: self‐reflectiveness (SR), which is the attitude of questioning one's own judgments; and self‐certainty (SC), which is the unwillingness to modify and correct one's own convictions. There is little information about cognitive insight in healthy participants (HP). Here we investigated the socio‐demographic and neuropsychological correlates of cognitive insight in 50 HP who were administered the BCIS and a comprehensive neuropsychological battery. The global BCIS R‐C index correlated positively with age and WCST perseverative errors. SR correlated positively with age. These data support the hypothesis that a less self‐reflective and more self‐confident style is cognitively functional in HP. Thus, what has been found malfunctioning in mental illnesses is adaptive in HP. Future studies should consider a wider range of factors that might affect this complex construct. Copyright © 2011 John Wiley & Sons, Ltd.     

Drawing with oblique coordinates: on a single case

We describe a patient with right hemisphere damage affected by mild left visuo-spatial neglect and constructional apraxia. During the rehabilitation, he failed to draw a draught-board using horizontal and vertical trajectories, but he performed it successfully using oblique trajectories. These observations suggested an impairment of vertical/horizontal spatial coordinates system. In copying tasks including figure elements in different orientations he drew more accurately components in oblique orientation, whereas failed to reproduce components in horizontal orientation. The patient performed visuospatial perceptual and perceptual-imaginative tasks successfully. From these findings, it is possible to suggest that the oblique coordinate system of reference operates independently of vertical and horizontal coordinate systems in building a complex figure and that, therefore, cardinal orientation do not constitute a reference norm to define oblique orientation, as previously suggested.     

Affect, unconscious and sensemaking. A psychodynamic, semiotic and dialogic model

The work presents a psychodynamic, semiotic and dialogical model of affect and of the role it plays in sensemaking. The model is based on the following three general assumptions.A) Affective semiosis works in accordance to the dynamic unconscious which Freud conceptualized in terms of primary process. According to this interpretation, the unconscious is the mind’s homogenising way of functioning, which transforms every categorical relation into a relation of identity. B) Affect is the generalized, homogenising and absolutizing embodied basic intersubjective meanings according to which experience is interpreted. C) Affective semiosis performs both the grounding and regulative functions in sensemaking, orienting the way people interpret experience.     

Reviewers and the Detection of Deceptive Information in Recorded Interviews

Being able to detect deceptive information early is worthwhile for recruiters and other information‐based organizational workers; unfortunately, people generally are not good at detecting deception successfully. We conducted an experiment to determine how successful reviewers can be at detecting deception in several types of dispersed interviews. The results indicated that reviewers were more accurate at detecting deceptive information than were participant interviewers; that a warning about deception's presence improved reviewers' detection accuracy; and that a warning did not have any effect on reviewers' number of false alarms between text and audio media. These findings imply that if reviewers are warned about the possible presence of deception, organizations might be able to minimize the chance of hiring high‐risk job applicants.     

Newborns' preference for goal-directed actions

The central role of sensory-motor representations in cognitive functions is almost universally accepted. However, determining the link between motor execution and its sensory counterpart and when, during ontogenesis, this link originates are still under investigation. The aim of the present study is to investigate whether at birth this link is already present and 2-day-old newborns are able to discriminate between visual cues indicating goal-directed or non-goal-directed actions. Here, with a preferential looking technique, a hand grasping a ball was the observed movement and we orthogonally manipulated the three factors necessary to successfully reach the goal: (a) presence of the ball, (b) direction of the arm movement, and (c) hand shaping. Results indicated that newborns orient more frequently and look longer at a hand shape for whole hand prehension but only when the movement is directed away from the body and toward the external world. In addition, newborns prefer the away from the body movement only when the object is present. We argue that newborns prefer a movement directed toward the external world only when it may develop into a purposeful movement because of the presence of the to-be-grasped object. Overall, our results support the existence of primitive sensory-motor associations since the first days after birth.     

Impaired awareness of movement disorders in Parkinson’s disease

Background

This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson’s disease (PD) and motor fluctuations (dyskinesias, wearing off, on–off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits by comparing the on and off states using motor scales and an extensive battery of tests to assess cognitive and behavioral functioning.

Methods

PD patients were compared on three different scales that we have devised to measure awareness of movement disorders: Global Awareness of Movement (GAM) Disorders, dyskinesia/hypo-bradykinesia rating scales.

Results

Data showed that PD patients had greater awareness and psychological suffering in the off state than in the on state. In particular, they were troubled by motor disabilities related to hypokinesias and had mood-related symptoms and a perception of disability in activities of daily living. Interestingly, patients only showed a selective reduction of awareness of movement disorders associated with executive functions and related to dyskinesias in the on state, compared to a preserved awareness of hypokinesias in the off state. On the contrary, no association with executive functions was found in the off state.

Conclusion

Our findings suggest that the dopaminergic overstimulation of mesocorticolimbic pathways may cause a dysfunction of prefrontal–subcortical connections related to the impaired insight.     

Construct Validity of ADHD-IN,ADHD-HI,ODD toward Adults,Academic and Social Competence Dimensions with Teacher Ratings of Thai Adolescents: Additional Validity for the Child and Adolescent Disruptive Behavior Inventory

Confirmatory factor analysis was used to test the construct validity of an attention-deficit/hyperactivity disorder-inattention, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, oppositional defiant disorder toward adults, academic and social competence factor model with teacher ratings of Thai adolescents (n = 872) with the Child and Adolescent Disruptive Behavior Inventory. The five-factor model resulted in an adequate fit in an absolute sense (i.e., CFI = .960; TLI = .985; RMSEA = .065; and WRMR = .883). All the items had significant and substantial loadings on their respective factors (i.e., > .78) with the five-factors showing discriminant validity. The five-factor model also resulted in similar results for boys and girls separately as well as younger and older adolescents. The current findings with the teacher version of the measure in conjunction with earlier research with mothers’ and fathers’ ratings of Brazilian, Thai, and American children (Burns et al., Psychological Assessment, 20, 121-130, 2008) and Thai adolescents (Burns et al., Psychological Assessment, 21, 635-641, 2009) provide increasing support for the construct validity of Child and Adolescent Disruptive Behavior Inventory within multiple cultures. Procedures are also outlined to improve the content validity as well as test the construct validity of forthcoming parent and teacher DSM-V ADHD/ODD rating scales.     

Right‐wing authoritarianism,Big Five and perceived threat to safety

Using structural equations modelling, we performed a secondary analysis of the data collected by the Italian Observatory of the North West (Italian national sample, N = 976) to investigate the direct, mediated and moderated relations connecting the Big Five personality factors and perceived personal and societal threat to safety with right‐wing authoritarianism (RWA). Openness, Conscientiousness and perceived societal threat to safety exerted additive effects on RWA; the relation between Openness and RWA was partially mediated by societal threat to safety and that between societal threat to safety and RWA was moderated by Openness. Limitations and possible developments of this research are discussed. Copyright © 2009 John Wiley & Sons, Ltd.