Vagus nerve stimulation therapy in a patient with treatment-resistant depression: a case report of long-term follow-up and battery end-of-service

This is the first case report of a patient who received long-term (69-month) adjunctive vagus nerve stimulation (VNS) therapy for treatment-resistant depression (TRD) and reached VNS battery end-of-service (EOS). The patient is a 41-year-old female with depression who entered a study of adjunctive VNS therapy for TRD. Her Hamilton Rating Scale for Depression (HAM-D) scores dropped from a mean of 33.5 (pre-implantation baseline period) to 16 at the end of the 12-week acute-phase treatment period, and then fluctuated from <7 (normal range) to scores in the moderately depressed range (approximately 20) during long-term follow-up. Three and one-half years after VNS implantation, the patient's HAM-D scores began to increase from a score of 18 to a peak score of 27 approximately 16 months later (5-years post-implantation). The patient subsequently reported that she could no longer feel stimulation from the device and device interrogation 2 weeks later indicated battery EOS. The patient was hospitalized due to worsened depression, the pulse generator was replaced, and medication adjusted. HAM-D scores through the subsequent 9 months of follow-up returned to a pattern of fluctuations within the range noted during the long-term follow-up period prior to VNS battery EOS.     

Transposition asymmetry in immediate serial recall

When participants confuse the position of items in immediate serial recall, they tend to recall transposed items too early rather than too late. This asymmetry of transposition errors was observed in four experiments. It increased as a function of list length, but was independent of report order, output position, cueing condition, and recall mode. The transposition asymmetry is consistent with error patterns in free recall and in regular speech production where transpositions are usually forward-looking. The asymmetry of transposition errors is discussed in terms of models of serial memory.     

Conditioned inhibition of cocaine seeking in rats

Despite its potential relevance to the treatment of drug abuse, conditioned inhibition of drug seeking has not been systematically investigated before. In this study, rats could self-administer cocaine by lever pressing whenever a click or tone was present. Responding was not reinforced when a light was present. The light was presented simultaneously with the click (i.e., in an excitatory context) in 1 group, but the light was always presented alone in another group. When it was later presented in compound with the tone, the light was a highly effective conditioned inhibitor, suppressing cocaine seeking by 92% in the former group and by 74% in the latter. These results suggest ways to improve cue-oriented behavioral treatments for drug abuse.     

The relationship of thought-action fusion to pathologicial worry and generalized anxiety disorder

Meta-cognitive beliefs associated with pathological worry and generalized anxiety disorder (GAD) may encompass the likelihood subtype of thought-action fusion (TAF), the belief that one's thoughts can influence outside events. In the current study of 494 undergraduate college students, positive correlations between scores on the Penn State Worry Questionnaire (PSWQ) and the two Likelihood subscales of the TAF Scale were found, and participants endorsing at least some DSM-IV diagnostic criteria for GAD scored significantly higher on both TAF-Likelihood subscales than participants reporting no GAD symptoms. However, these TAF scales did not predict GAD diagnostic status with PSWQ included as a predictor. In contrast to previous research, the TAF-Moral scale did not correlate with worry. Relationships between TAF, pathological worry, and meta-cognition are discussed in relation to GAD.     

Grammatical gender in the production of single words: some evidence from Greek

The present study investigated the effect of prior grammatical gender information provided by the production of a bare noun on the production of a syntactically unrelated, gender-inflected color adjective. The target language was Greek. A lexical priming task involving picture naming was employed. Participants saw a series of pictures, some in color and some in black-and-white; they had to name a black-and-white picture with the single noun (prime) and a color picture with the appropriately inflected color adjective (target). Prior gender information was shown to affect subsequent production of gender-marked words. The effect was restricted to nouns of one gender class (masculine) only. The implications of these results for the representation and processing of gender in production are discussed.     

A medication screening tool for cognitive aging researchers

A Web-based medication screening tool that provides researchers with information about side effects associated with medications commonly used by older participants is described. This tool can be used for research purposes to better separate the effects of normal, healthy aging processes from the deleterious effects often associated with medication usage. Researchers can use this tool, called SMART (Screening Medications: Aging Research Taxonomy), to (a) obtain information pertaining to the cognitive, sensory, and motor side effects associated with specific medications and (b) screen medications in their research for side effect severity. The Web address for the tool is www.psychology.gatech.edu/SMART     

Barriers and Bridges to Intimacy and Mutuality: A Critical Review of Sexual Advice Found in Self-Help Bestsellers

Sexuality in a committed relationship is based ideally on both intimacy and mutuality. Gender socialization may limit women's and men's capacities in these two important areas of sexual relationships. This article describes the results of a content analysis of nine best-selling popular press books on the New York Times Bestseller List between 1988 and 1998 according to their advice related to sexual intimacy and mutuality. Books were analyzed to determine the degree to which they built barriers or bridges to the development of intimacy and mutuality. Results indicate that while most authors offered advice that built bridges to intimacy, several built barriers to the development of mutuality. Implications for therapists are discussed.     

Neuropsychological Functioning in Chronic Lyme Disease

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.     

Effects of compounding drug-related stimuli: escalation of heroin self-administration

Previous experiments have demonstrated that presenting independently established discriminative stimuli in compound can substantially increase operant responding maintained by food reinforcement or shock avoidance. Recently, this phenomenon was also shown to occur with cocaine self-administration. The present study further assessed the generality of these stimulus-compounding effects by systematically replicating them with heroin self-administration. Rats' nose-poke responses produced intravenous heroin (0.025 mg/kg per infusion) on a variable-ratio schedule when either a tone or a light was present. In the absence of these stimuli, responding was not reinforced. Once discriminative control by the tone and light had been established, the stimuli were presented in compound under extinction (with heroin discontinued) or maintenance conditions (with heroin available during test-stimulus presentations). In extinction, the tone-light compound increased responding approximately threefold compared to tone or light alone. Under maintenance conditions, compounding increased heroin intake approximately twofold. These effects closely matched those obtained earlier with cocaine. This consistency across pharmacological classes and across drug and nondrug reinforcers further confirms that (a) self-administered drugs support conditioning and learning in a manner similar to that supported by other reinforcers; and (b) multiple drug-related cues interact in lawful and predictable ways to affect drug seeking and consumption.