Sexual disorders not otherwise specified: compulsive, addictive, or impulsive?

Paraphilias are recurrent and intense sexually arousing fantasies, sexual urges, or behaviors generally involving nonhuman objects. These paraphilias cause the suffering or humiliation of the patient or patient's partner, or children, or other nonconsenting persons. However, in many patients symptoms involve more culturally acceptable patterns (eg, repetitive masturbation, Internet pornography); such hypersexual symptoms have been labeled as compulsive, addictive, or impulsive. Growing evidence supports the existence of a discrete syndrome characterized by recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving patterns that fall outside the definition of paraphilia. There is, however, high comorbidity with paraphilia. While such symptoms have been labeled as sexual compulsion or addiction, these terms are problematic in this context. Modern nosology has neglected this entity, although the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), category of sexual disorders not otherwise specified includes hypersexual behaviors as an example. We suggest that the DSM-IV category of sexual disorders be modified to include explicitly diagnostic criteria for a disorder characterized by hypersexual symptoms involving patterns that fall outside of the current definition of paraphilia. The disorder might be classified as one of the paraphilias, or as paraphilia-related. In the absence of a comprehensive understanding of the pathogenesis of this disorder, we suggest that it simply be termed hypersexual disorder.     

An abbreviated PTSD checklist for use as a screening instrument in primary care

Although the importance of recognizing posttraumatic stress disorder (PTSD) in primary care has been well-established, routine screening for PTSD remains unfeasible for many primary care clinics because of the length of the available screening instruments. Thus, the purpose of this work was to develop and validate a brief screening tool for PTSD. In Study 1, four short forms of the PTSD Checklist-civilian version were identified that captured a majority of the variance in the measure. In Study 2, the performance of these short forms was evaluated in a separate sample of primary care patients. We found that both two-item and six-item versions have adequate psychometric properties for screening purposes and suggest that the selection of one version over the other depends on the specific needs of each primary care clinic.     

Suppositions, extensionality, and conditionals: a critique of the mental model theory of Johnson-Laird And Byrne (2002)

P. N. Johnson-Laird and R. M. J. Byrne proposed an influential theory of conditionals in which mental models represent logical possibilities and inferences are drawn from the extensions of possibilities that are used to represent conditionals. In this article, the authors argue that the extensional semantics underlying this theory is equivalent to that of the material, truth-functional conditional, at least for what they term "basic" conditionals, concerning arbitrary problem content. On the basis of both logical argument and psychological evidence, the authors propose that this approach is fundamentally mistaken and that conditionals must be viewed within a suppositional theory based on what philosophical logicians call the Ramsey test. The Johnson-Laird and Byrne theory is critically examined with respect to its account of basic conditionals, nonbasic conditionals, and counterfactuals.     

Hypnotic disgust makes moral judgments more severe

Highly hypnotizable participants were given a posthypnotic suggestion to feel a flash of disgust whenever they read an arbitrary word. They were then asked to rate moral transgressions described in vignettes that either did or did not include the disgust-inducing word. Two studies show that moral judgments can be made more severe by the presence of a flash of disgust. These findings suggest that moral judgments may be grounded in affectively laden moral intuitions.     

Neuroleptic malignant syndrome: diagnostic and therapeutic dilemmas

Neuroleptic malignant syndrome (NMS) is a life threatening medical state complicating the use of antipsychotic medications and other drugs that affect the dopaminergic system on administration or withdrawal. The condition was recognised nearly half a century ago, shortly after the discovery of antipsychotic medications. However, there are still no systematic studies about NMS. There are no definitive guidelines on its treatment. Although early recognition is emphasised and usually possible, delayed diagnosis is not rare. We here report on a case of NMS complicated by renal failure, and possibly respiratory failure. The report underscores the seriousness of delayed diagnosis and puts forward a comprehensive management recommendation based on our experience and the existing literature.     

The wane of childhood amnesia for autobiographical and public event memories

We modified Bruce, Dolan, and Phillips-Grant's (2000) threshold procedure for determining the wane of childhood amnesia. In two experiments, undergraduates labelled childhood events (e.g., your first permanent tooth came in) as know or recollect memories and estimated their age at the event's occurrence. In both studies the estimated transition from mostly know memories to mostly recollect memories was roughly 4.7 years. This transition estimate was replicated in a sample of adults (ages 24-65 years) with both Bruce et al.'s event-generation task and the Experiment 1a questionnaire. By contrast, in two experiments a transition estimate of roughly 6 years was found for undergraduates' memories of public events (e.g., the Challenger explosion). The wane of childhood amnesia appears to occur around 4.7 years.     

How bad is a 10% chance of losing a toe? Judgments of probabilistic conditions by doctors and laypeople

We presented a Web questionnaire to 139 physicians and medical researchers and 109 laypeople. The subjects made judgments of badness and importance of prevention for eight medical conditions at each of seven different probability levels. By assuming that the response to each of the 56 risks was monotonically related to transformations of the probability and of the disutility of the condition, we could assess the relative effect of probability and disutility on each subject's judgments. Physicians' judgments were more sensitive than laypeople's judgments to changes in probability. Older and female laypeople were less sensitive to probability (and correspondingly, more responsive to differences in severity among medical conditions). Laypeople varied more than physicians in their responsiveness to probability. These results point to general individual differences in the effect of probability on evaluations of medical risks. They may also provide insight into causes and noncauses of physician-patient miscommunication.