Assessment of Executive Functions after Treatment of Childhood Acute Lymphoid Leukemia: a Systematic Review

Neuropsychology Review - Individuals treated for childhood acute lymphoblastic leukemia (ALL) have a high survival rate. This fact, however, may lead to neurocognitive impairments in survivors, as...     

Thought-shape fusion in anorexia nervosa: an experimental investigation

Cognitive biases and cognitive distortions have been implicated as important factors in the development and maintenance of many disorders. The concept of thought-shape fusion (TSF) in eating disorders was developed by Shafran, Teachman, Kerry, and Rachman (British Journal of Clinical Psychology 38 (1999) 167) as a variant of thought-action fusion, described by Shafran, Thordarson and Rachman (Journal of Anxiety Disorders 10 (1996) 379). TSF occurs when thinking about eating certain types of food increases a person's estimate of their shape and/or weight, elicits a perception of moral wrongdoing, and/or makes the person feel fat. Shafran et al. (1999) examined both the psychometric and experimental properties of TSF in an undergraduate sample. This paper reports an extension of this work to a clinical group (N=20) of patients with anorexia nervosa. After completing a set of relevant questionnaires, participants were asked to think about a food which they considered extremely fattening. They were then asked to write out the sentence, "I am eating--.", inserting the name of the fattening food in the blank. After being asked to rate their anxiety, guilt, feelings about their weight, morality, etc., participants were given the opportunity to neutralize their statement in any way they chose. The majority of the participants neutralized in ways consistent with the findings of Shafran et al. (1999). The results are discussed in terms of cognitive-behavioural formulations of eating disorders, and of the influence of cognitive biases and cognitive distortions on the processing of information relevant to food, weight and shape in anorexia nervosa.     

Extinction-induced immobility in the water maze and its neurochemical concomitants in aged and adult rats: a possible model for depression?

Extinction of escape behavior in the water maze due to the removal of the platform, was hypothesized to induce a negative state, including the development of immobility, which is held to reflect a state of "despair" when measured in the forced swimming test. 27 aged and 8 adult animals (26 and 3 months old Wistar rats, respectively) were tested in the water maze during nine days with a platform hidden, followed by 7 days of extinction trials with the platform absent. As expected, both age groups developed immobility over the extinction trials, with the aged showing more than the adults. To examine whether the age difference in immobility was related to performance differences during acquisition, the aged were subdivided into superior, intermediate and inferior learners (n = 9 per group) on the basis of overall times to platform during acquisition, and compared with each other and the adults. Results showed that the aged inferior learners displayed the highest levels of immobility among the aged. Immobility scores were then correlated with post-mortem neurotransmitter contents in the hippocampus and ventral striatum. In the ventral striatum, levels of immobility were correlated with levels of acetylcholine, dopamine and the metabolite dihydroxyphenylacetic acid in the aged, and with norepinephrine in the adults. The data support the hypothesis that multiple extinction trials in the water maze result in immobility that may indicate "behavioral despair," and that striatal neurotransmitter systems correlate with the degree of its expression. The concept of extinction-induced despair is held to provide the promise of a conceptual and empirical model of human depression that is the consequence of loss of reinforcers.     

A neuropsychiatric developmental model of serial homicidal behavior

Serial sexual homicide has been the object of intensive study from forensic psychiatric, criminological, developmental, and sociological perspectives. In contradistinction to these approaches, neuropsychiatric concepts and methods have received relatively little attention in this area. In this article we adopt a neuropsychiatric developmental perspective and undertake a review of the psychiatric literature on violence and autism spectrum disorders. Our analysis of this literature suggests the presence of an association between autism spectrum psychopathology and serial homicidal behavior. Recommendations for further research to help clarify the nature of this association are briefly discussed.     

Illusory illusions: the significance of fixation on the perception of geometrical illusions

Some well-known geometrical illusions disappear when the eyes are fixating and saccades are suppressed for a period of time. This disappearance is not accompanied by fading due to stabilisation of the retinal image. Any saccade made on purpose restores the illusion immediately. The fixation time after which some illusions disappeared was measured for four illusions and four subjects each. Effects of practice have been observed after measurements were repeated on successive days. Present theories of vision cannot readily explain the effect.     

Engagement and outcome in the treatment of bulimia nervosa: first phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy

Despite the major advances in the development of treatments for bulimia nervosa, drop-outs and a lack of engagement in treatment, continue to be problems. Recent studies suggest that the transtheoretical model of change may be applicable to bulimia nervosa. The aim of this study was to examine the roles of readiness to change and therapeutic alliance in determining engagement and outcome in the first phase of treatment. One hundred and twenty five consecutive female patients meeting DSM-IV criteria for bulimia nervosa took part in a randomised controlled treatment trial. The first phase of the sequential treatment compared four sessions of either cognitive behavioural therapy (CBT) or motivational enhancement therapy (MET) in engaging patients in treatment and reducing symptoms. Patients in the action stage showed greater improvement in symptoms of binge eating than did patients in the contemplation stage. Higher pretreatment scores on action were also related to the development of a better therapeutic alliance (as perceived by patients) after four weeks. However, pretreatment stage of change did not predict who dropped out of treatment. There were no differences between MET and CBT in terms of reducing bulimic symptoms or in terms of developing a therapeutic alliance or increasing readiness to change. The results suggest that the transtheoretical model of change may have some validity in the treatment of bulimia nervosa although current measures of readiness to change may require modification. Overall, readiness to change is more strongly related to improvement and the development of a therapeutic alliance than the specific type of treatment.     

The assessment of obsessionality using the Padua inventory: its validity in a British non-clinical sample

The Padua Inventory (PI) is a measure of obsessive–compulsive phenomena, which permits measurement of both number and severity of symptoms. Data is available from Italy, the US, the Netherlands and Australia on non-clinical samples. The present study provides a psychometric evaluation of the PI on a British non-clinical sample (N=1855). Comparisons are made with other data and further suggestions for the use of the PI are made. Results from the present study indicate that the PI has similar, though not identical, factor structure to previous studies, adequate internal reliability and construct validity. Four factors emerged, containing clusters of items broadly relating to ‘impaired control over mental activities/doubting', ‘contamination', ‘checking' and ‘worries about losing control over motor behaviour' and these included most of the items loading on the same factors in earlier studies together with additional items.The relationships of age and gender with the PI scores are investigated. Differences were found from the Sanavio (1988) [Sanavio, E. (1988). Obsessions and compulsions: the Padua Inventory. Behaviour Research and Therapy, 26, 169–177.] Italian sample. These differences are in keeping with other available data from British samples and other data on the epidemiology of Obsessive Compulsive Disorder. The five factor structure found in the one study using clinical and non-clinical subjects is discussed in relation to the present analyses.     

Attention and social functioning in children with malformations of cortical development and stroke

Attention and social functioning and their interrelationships have not been routinely examined in children with early brain insult (EBI). This study aimed to describe attention and social functioning in children with two types of EBI: malformations of cortical development (MCD) and stroke. Children diagnosed with MCD (n = 14, 6 males) or stroke (n = 14, 8 males) aged 8 to 14 years (M = 12 years 11 months) completed neuropsychological assessments to examine attention processes. Primary caregivers completed a questionnaire to assess executive components of children's attention and teachers completed a questionnaire to measure children's social functioning. Brain scans (MRI or CT) were coded by a pediatric neuroradiologist. Higher rates of impairments in attention and social function were found in children with EBI compared with normative expectations. Children with MCD experienced more global and clinically significant levels of impairment than children with stroke; though impairments were present in both groups. A strong association between executive components of attention and social function was observed. In addition, complex attention processes were associated with social function. The findings emphasize the reciprocity between attention, behavior and social outcomes, and the vulnerability of social function following EBI.     

Presymptomatic Testing for Neurogenetic Diseases in Brazil: Assessing Who Seeks and Who Follows through with Testing

Diagnostic tests are available to detect several mutations related to adult-onset, autosomal dominant, neurodegenerative diseases. We aimed to describe our experience in a presymptomatic testing program run by the Brazilian Public Health System from 1999 to 2009. A total of 184 individuals were eligible for presymptomatic testing due to a risk for spinocerebellar ataxia (SCA) - SCA3 (80%), Huntington’s disease (11.9%), familial amyloidotic neuropathy (4.3%), SCA1, SCA2, SCA6, or SCA7. Most were women (70%), married (54%), and had children prior to presymptomatic testing (67%). Their mean age at entrance was 34 (SD = 11 years). Educational level was above the average Brazilian standard. After receipt of genetic counseling, 100 individuals (54%) decided to undergo testing; of these, 51 were carriers. Since no individual returned for post-test psychological evaluation, we conducted a subsequent survey, unrelated to test disclosures. We contacted 57 individuals of whom 31 agreed to participate (24 had been tested, 7 had not). Several ascertainment concerns relating to these numerous losses prevented us from generalizing our results from this second survey. We concluded that: decision-making regarding presymptomatic testing seems to be genuinely autonomous, since after genetic counseling half the individuals who asked for presymptomatic testing decided in favor and half decided against it; general characteristics of Brazilians who sought presymptomatic testing were similar to many European samples studied previously; and individuals at risk for SCA3 may be at greater risk of depression. Although no clear-cut reason emerged for rejection of follow-up psychological sessions after presymptomatic testing, this finding suggests adjustments to our presymptomatic testing program are necessary.