The paradox of quetiapine in obsessive-compulsive disorder

Schizophrenia and obsessive-compulsive disorder (OCD) have historical, clinical, and epidemiological links. The clinical use of atypical neuroleptics (ie, dual serotonin-dopamine antagonists) to treat both conditions sheds a new light on them. We report the first two cases of obsessive-compulsive symptoms (OCS) induced by quetiapine in schizophrenia patients. A case of successful augmentation by quetiapine in refractory OCD is also presented. A review of the literature on OCS induced by atypical neuroleptics follows. This paradoxically induced OCD symptomology in schizophrenia patients administered atypical neuroleptics is discussed from new pathophysiological and clinical perspectives. The discussion emphasizes the prognostic implications of OCS in schizophrenia and available therapies for this comorbidity.     

Development of subtype selective GABAA modulators

Drugs modulating gamma-aminobutyric acid (GABA) transmission via the benzodiazepine (BZ) site on the gamma-aminobutyric acid type A (GABAA) receptor have been in widespread use for more than 40 years to treat anxiety, epilepsy, and sleep disorders. These drugs have been shown to be safe, well tolerated, and effective although the mechanism by they produce a myriad of pharmacologic effects remains elusive. In recent years it has been discovered that, although the GABAA receptor is widely distributed in the brain, the substructure and composition of the receptor differs from between brain regions. Termed "GABAA receptor subtypes" their discovery leads to speculation that different subtypes may mediate specific effects of BZs such as anxiety or sedation. The phenotypic analysis of transgenic knock-in and knock-out mice in which particular GABAA receptors were rendered insensitive to the effects of BZ while others were unaffected confirmed this speculation. Subsequently, subtype-specific GABAA ligands were developed that, for example, retained the anxiolytic effects of BZs but were devoid of their sedative effects. Therefore, it may be possible to develop effective anxiolytic compounds that have a much reduced side-effect profile compared with existing drugs.     

A confirmatory model for depression among Japanese American and part-Japanese American adolescents

A confirmatory model integrating Japanese ethnicity, cultural identity, and depression was developed (N = 140). The model incorporated the Center for Epidemiologic Studies-Depression Scale (CES-D), Major Life Events Scale, and Japanese Cultural Scale. Japanese American adolescents scored higher on the Japanese Cultural Scale and reported fewer depressive symptoms on the CES-D total and on 2 of the 3 CES-D factors than part-Japanese American adolescents. Predictors for depression were being Japanese American vs. part-Japanese American, female gender, and culturally intensified events. A significant interaction of behavior by self-identification was noted. The model had good overall fit and suggested that the formation of cultural identity may contribute to depressive symptoms experienced by adolescents, particularly adolescents of mixed heritage.     

Abstract analogies and positive transfer in artificial grammar learning.

Following Brooks and Vokey (1991), we show that positive transfer to new items generated from an artificial grammar in which the vocabulary has been changed from training to test can be based on "abstract analogy" to specific training items (specific similarity) rather than abstraction of a grammar and symbol remapping rules, even with remapping unique to each test item. The results confirm that transcendence over symbols provides no support for the implicit learning of abstract structure. Ironically, they also show that the effect of specific similarity does not depend on surface characteristics of the items, but the residual effect of grammaticality does.     

Intuition and autism: a possible role for Von Economo neurons

Von Economo neurons (VENs) are a recently evolved cell type which may be involved in the fast intuitive assessment of complex situations. As such, they could be part of the circuitry supporting human social networks. We propose that the VENs relay an output of fronto-insular and anterior cingulate cortex to the parts of frontal and temporal cortex associated with theory-of-mind, where fast intuitions are melded with slower, deliberative judgments. The VENs emerge mainly after birth and increase in number until age 4 yrs. We propose that in autism spectrum disorders the VENs fail to develop normally, and that this failure might be partially responsible for the associated social disabilities that result from faulty intuition.     

New approaches to demystifying insight

After a person has become stuck on a problem, they sometimes achieve a clear and sudden solution through insight--the so-called Aha! experience. Because of its distinctive experience, the origins and characteristics of insight have received considerable attention historically in psychological research. However, despite considerable progress in characterizing insight, the underlying mechanisms remain mysterious. We argue that research on insight could be greatly advanced by supplementing traditional insight research, which depends on a few complex problems, with paradigms common in other domains of cognitive science. We describe a large set of mini-insight problems to which multiple methods can be applied, together with subjective reports to identify insight problem-solving. Behavioral priming and neuroimaging methods are providing evidence about what, where, and how neural activity occurs during insight. Such evidence constrains theories of component processes, and will help to demystify insight.     

Toward a taxonomy of attention shifting: Individual differences in fMRI during multiple shift types

Although task switching is often considered one of the fundamental abilities underlying executive functioning and general intelligence, there is little evidence that switching is a unitary construct and little evidence regarding the relationship between brain activity and switching performance. We examined individual differences in multiple types of attention shifting in order to determine whether behavioral performance and fMRI activity are correlated across different types of shifting. The participants (n=39) switched between objects and attributes both when stimuli were perceptually available (external) and when stimuli were stored in memory (internal). We found that there were more switchrelated activations in many regions associated with executive control—including the dorsolateral and medial prefrontal and parietal cortices—when behavioral switch costs were higher (poor performance). Conversely, activation in the ventromedial prefrontal cortex (VMPFC) and the rostral anterior cingulate was consistently correlated with good performance, suggesting a general role for these areas in efficient attention shifting. We discuss these findings in terms of a model of cognitive-emotional interaction in attention shifting, in which reward-related signals in the VMPFC guide efficient selection of tasks in the lateral prefrontal and parietal cortices.     

Measuring health beliefs on the Internet: A comparison of paper and Internet administrations of the Multidimensional Health Locus of Control Scale

A growing number of studies have supported the use of unidimensional psychometric test instruments administered via the Internet; however, support for the use of multidimensional scales is weak. The present study compares paper and Internet administrations of the Multidimensional Health Locus of Control (MHLC) Scale (Wallston & Wallston, 1981). In terms of reliabilities and factor structures, the Internet data were found to be at least as good as the paper data. MHLC scores were comparable for paper and Internet administrations, although the Internet sample scored significantly lower on the Powerful Others subscale. Overall, the results show that administration of the MHLC Scale via the Internet can produce data comparable to that obtained by pen-and-paper methods. However, it is concluded that generalization of these findings beyond the psychometric test instrument and sampling procedures used here is not warranted.     

Communication strategies to promote spiritual well-being among people with dementia

Declining communication skills in dementia threaten a person's sense of self. Building on enduring capabilities, pastoral visitors can significantly enhance spiritual well-being through the use of individualized, person-centered strategies. This article outlines the primary spiritual needs of older adults with dementia and some general strategies to improve communication based on enduring abilities. Detailed examples illustrate how these personhood-centered strategies can meet spiritual needs by connecting with individuals with dementia through life stories and through helping them to participate in religious life.