Gilles de la Tourette syndrome in India: two cases.

Two cases of Gilles de la Tourette syndrome from India are presented. The symptomatology of Tourette syndrome is the same as that documented in western populations which suggests biological factors in the aetiology of the syndrome.     

The wish to be soothed as a resistance.

As the analyst makes the correct interpretations of resistance in the opening phase of an analysis, the patient begins to feel understood, often for the first time. This feeling allays anxiety and depressive affects, and the patient comes to experience the analyst as a soother. These initial exchanges may lay the foundation for a positive transference which acts as a buffer against turbulent transferences. In some patients this positive transference develops rapidly, often with prompt symptom remission. In others--children as well as adults--the analyst must persistently interpret defensive regressions before a stable, positive transference can emerge. In either case, in order to avoid the analysis of conflict, some patients become resistant to the analysis of the wish to be soothed. Many of these patients have had a childhood filled with traumatic parental stimulation or rejection. Two clinical accounts illustrate these contentions.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Reliability and validity of the Cognitive Slippage Scale in two populations.

Analyses of responses from a clinical sample of 120 patients (primarily schizophrenics) and from 158 college students to the Cognitive Slippage Scale, a scale designed by Miers and Raulin to identify speech deficits and confused thinking in schizophrenic and schizotypal personality disorders showed high internal reliability; Cronbach's coefficients alpha were .89 and .86 in the clinical and college student samples, respectively. The mean scale scores significantly differentiated the two samples. Also, change scores over 4 wk. showed adequate stability for both samples. Item analysis indicated Items 11, 20, 21, and 28 may not reliably discriminate between schizophrenic and college student samples. Over-all, these preliminary results are consistent with the reliability and validity of the scale.     

Depression and immunocompetence: a review of the literature.

Recent evidence suggests that there is a relationship between depression and immunity. On the basis of these studies, it has been argued that depressed mood may increase susceptibility to disease by means of aberrations occurring within the immune system. Empirical research investigating the relationship between depression and immunity is reviewed here. Studies examining both clinical and nonclinical manifestations of depression are discussed and evaluated. This review reveals that indexes of immunocompetence are lower among people exhibiting depressive symptomology and suggests that immune alterations may be more related to dysphoric mood than to specific situations or events. Alternative hypotheses accounting for links between depressed affect and altered immune states are provided, and suggestions for future research are offered.     

From Monroe to Moreau: an analysis of face naming errors.

Functional models of face recognition and speech production have developed separately. However, naming a familiar face is, of course, an act of speech production. In this paper we propose a revision of Bruce and Young's (1986) model of face processing, which incorporates two features of Levelt's (1989) model of speech production. In particular, the proposed model includes two stages of lexical access for names and monitoring of face naming based on a "perceptual loop". Two predictions were derived from the perceptual loop hypothesis of speech monitoring: (1) naming errors in which a (correct) rare surname is erroneously replaced by a common surname should occur more frequently than the reverse substitution (the error asymmetry effect); (2) naming errors in which a common surname is articulated are more likely to be repaired than errors which result in articulation of a rare surname (the error-repairing effect). Both predictions were supported by an analysis of face naming errors in a laboratory face naming task. In a further experiment we considered the possibility that the effects of surname frequency observed in face naming errors could be explained by the frequency sensitivity of lexical access in speech production. However, no effect of the frequency of the surname of the faces used in the previous experiment was found on face naming latencies. Therefore, it is concluded that the perceptual loop hypothesis provides the more parsimonious account of the entire pattern of the results.     

Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.     

On the clinical utility of the concept of depressive affect as signal affect.

The author reviews the scant literature relating to the concept of depressive affect as an affect parallel to anxiety. Then, through the presentation of detailed clinical psychoanalytic data, in particular the patient's associations to interpretation, he demonstrates the value to the conduct of a psychoanalysis of an awareness of the role of depressive affect as a signal affect that triggers defense.     

Scientific rewards and conflicts of ethical choices in human subjects research.

The primary responsibility of the American Psychological Association's (APA) Committee on Standards in Research (CSR) is to advise the APA on issues and standards related to the protection of human participants in psychological research. A related goal is to enhance the use of good ethical practices by APA members. The purpose of this article is to foster the view of research ethics not as an affront to the integrity of sound research, but as opportunities for scientific rewards, including increased understanding of the meaning of data, enhanced recruitment, and the inclusion of more representative samples. Three ethical practices are discussed as examples of this general premise: respect for confidentiality, use of debriefing, and assurance that participants are noncoerced volunteers. The Committee's intent is to promote consideration of these issues, not to promulgate specific guidelines or procedures.