The relationship between miscellaneous symptoms and major symptom factors in obsessive-compulsive disorder

The diverse symptomatology of obsessive-compulsive disorder (OCD) is being increasingly regarded as reducible to a few symptom dimensions. However, prevailing factor-analytically derived models of symptom structure omit a number of the well-recognized “miscellaneous” symptoms of OCD. This study sought to determine whether miscellaneous OCD symptoms, ascertained by the Yale-Brown Obsessive-Compulsive Scale symptom checklist, could be differentially and reliably predicted by four symptom factors (obsessions and checking, symmetry and ordering, contamination and cleaning, and hoarding) in two independent groups of individuals with OCD (n = 381 and n = 107). Logistic regression analyses were used to determine the association of each of the miscellaneous symptoms with the symptom factors; then a single confirmatory factor analysis was conducted to test the model of associations in the smaller sample. Sixteen (89%) of the 18 symptoms examined were reliably predicted by one (11 items) or two (5 items) of the factors, with obsessions and checking and symmetry and ordering emerging as foremost predictors. The expanded four-factor model showed good fit with data from the second sample. Results are conceptually meaningful, but suggest the inadequacy of groupings based solely upon overt behaviors. These findings may aid clinical understanding of OCD and be of value to studies using symptom factors to guide investigation of its causes and correlates.     

Incidence of dysarthria in children with cerebellar tumors: a prospective study

The present study investigated dysarthric symptoms in children with cerebellar tumors. Ten children with cerebellar tumors and 10 orthopedic control children were tested prior and one week after surgery. Clinical dysarthric symptoms were quantified in spontaneous speech. Syllable durations were analyzed in syllable repetition and sentence production tasks. Localization of the cerebellar lesions were defined after manual transfer from individual 2D-MR images onto 3D images of a spatially normalized healthy brain. Cerebellar children showed few and mild clinical signs of dysarthria. No difference was present in the sentence production task compared to controls. In five cerebellar children, syllables were prolonged in the syllable repetition task after surgery. Syllable duration normalized in an additional four-week session in all but one case. The MR-analysis showed that superior paravermal cerebellar areas likely involved in dysarthria in adults (paravermal lobules HVI, Crus I) were not significantly affected. In children, speech impairments appear to be rare after cerebellar surgery because tumors most commonly affect posterior-inferior and medial parts of the cerebellum while critical cerebellar regions are likely spared. The results suggest a similar localization of speech functions in the cerebellum in children and adults.     

Rationality,group choice and expected utility

In this paper I propose a view uniformly extending expected utility calculations to both individual and group choice contexts. By way of three related cases I discuss the problems inherent in applying expected utility to group choice cases. I show that the problem with such group cases does not essentially depend upon the fact that more than one agent is involved. A modified strategy is then devised allowing the application of the expected utility formula to these otherwise problematic cases. One case, however, leads to contradiction. But recognizing the falsity of the proposition.(1) If an agent x knows options A and B are both available, and x knows that were he to do A he would be better off (in every respect) than were he to do B, then doing A is more rational for x than doing B,allows the resolution of the contradiction and also allows my modified strategy to resolve otherwise paradoxical cases of group choice such as the Prisoners' Dilemma.This paper is dedicated to my parents, Arleen Eichengreen and Alvin Richter, for their encouragement, understanding, and financial support. Very special thanks also go to Daniel Hunter, Richard Sharvy, and Paul Horwich. In addition I owe a great deal to discussions and correspondence with Michael Ferejohn, John Ferejohn, Kit Fine, Allan Gibbard, Dale Jamieson, Gregory Kavka, David Lewis, J. Karel Lambert, Alice Perrin, Howard Pospesel, Brian Skyrms, J. Howard Sobel, and Michael Tooley.     

Clinical significance of serum phenytoin level]

Phenytoin serum concentrations in 115 epileptics treated on an inpatient basis showed, in two groups, only relatively weak correlation with the dosage used. The range of variation was assigned a factor of 16. For individual patients there was observed a correlation between the dosage in mg/kg and the corresponding phenytoin serum concentration. The level of phenytoin serum concentration was not found to be related to the frequency of attacks. The effective phenytoin serum level showed interindividual differences and can be low as well as relatively high. Resulting from this is the need for determining, from the determination of serum concentrations, the effective serum concentration for each individual patient.     

Sex differences in self-reported coronary-prone factors

The FABA self-report questionnaire on coronary-prone behaviour was applied to 628 GDR subjects (343 males, 285 females), who included students, blue- and white-collar workers, and hypertensive patients, all split into three age groups (18–30, 31–50, and 51–65 years). Four scales had been previously established by factor analysis: Work Obsession (WO), Dominance/Competition (DC), Reactive Uncontrol (RU), and Need for Planning (PN). Two-tailed MANOVA and ANOVA were applied to analyse the effects of sex, age, and type of respondent (i.e. student, worker, or hypertensive) on scale means, using the defined sub-groups. No significant sex differences on WO and PN were found. With regard to DC, males of all sub-groups consistently rated themselves as more dominant and competitive than females. These differences were highly significant. RU was higher only in female students and female hypertensives. There was a significant age effect on DC and PN: the older the workers and hypertensives of both sexes, the more dominant and obsessed with planning they were. No influence of the type of respondent was apparent. Results are discussed in the light of cross-cultural research on gender differences and the particular socio-economic situation of the former GDR. © 1998 John Wiley & Sons, Ltd.     

Risk factors for adolescent marijuana use across cultures and across time.

An integrated analysis of the data from 3 different studies was conducted to examine the early psychosocial predictors of later marijuana use among adolescents. Longitudinal analysis of interview data was performed. The data used in the analysis were derived from (a) a sample of 739 predominantly White adolescents representative of the northeastern United States, (b) a sample of 1,190 minority adolescents from the East Harlem section of New York City, and (c) a sample of 1,374 Colombian adolescents from two cities in Colombia, South America. In 2 of the samples, participants were interviewed in their homes, and in the 3rd study, participants were assessed in school. The predictors included a number of variables from (a) the personality domain, reflecting the adolescents' conventionality and intrapsychic functioning; (b) the family domain, representing the parent-child mutual attachment relationship and parental substance use; (c) the peer domain, reflecting the peer group's delinquency and substance use; and (d) the adolescents' own use of legal drugs. The dependent variable was adolescent marijuana use. The results of the analysis demonstrated remarkable consistency in the risk and protective factors for later marijuana use across the 3 samples, attesting to the robust nature of these predictors and their generalizability across gender, time, location, and ethnic/cultural background. These findings have important implications for designing intervention programs. Programs aimed at preventing adolescent marijuana use can be designed to incorporate universal features and still incorporate specific components that address the unique needs of adolescents from different groups.     

Stress modulates the use of spatial versus stimulus-response learning strategies in humans

Animal studies provided evidence that stress modulates multiple memory systems, favoring caudate nucleus-based "habit" memory over hippocampus-based "cognitive" memory. However, effects of stress on learning strategy and memory consolidation were not differentiated. We specifically address the effects of psychosocial stress on the applied learning strategy in humans. We designed a spatial learning task that allowed differentiating spatial from stimulus-response learning strategies during acquisition. In 13 subsequent trials, participants (88 male and female students) had to locate a "win" card out of four placed at a fixed location in a 3D model of a room. Relocating one cue in the last trial allowed inferring the applied learning strategy. Half of them participated first in the "Trier Social Stress Test." Salivary cortisol and heart rate measurements were taken. Stressed participants used a stimulus-response strategy significantly more often than controls. Subsequent verbal report revealed that spatial learners had a more complete awareness of response options than stimulus-response learners. Importantly, learning performance was not affected by stress. Taken together, stress prior to learning facilitated simple stimulus-response learning strategies in humans-at the expense of a more cognitive learning strategy. Depending on the context, we consider this as an adaptive response.     

Memory search following valid and invalid abrupt-onset cues

The impact of abrupt-onset cues on memory search was investigated, where the abrupt-onset cue was a valid (Experiment 1), random (Experiment 2), or irrelevant (Experiment 3) predictor of the location containing the test probe. In Experiment 4, the abrupt-onset cue either preceded or followed the test probe. Sternberg-like functions were obtained in Experiments 1 and 2, with the effects of the abrupt-onset cue localized primarily in the intercept rather than the slope. Experiment 3 demonstrated that a spatially separated and irrelevant abrupt-onset cue increased latency even when all memory probes occurred at the fixation point. In Experiment 4, the robust impact of an abrupt-onset cue vanished, regardless of stimulus onset asynchrony, when it followed the target. We concluded that abrupt-onset cues captured attention regardless of their predictability, manifested as a delaying of search. However, once attention was captured by the target, a subsequent abrupt-onset stimulus had no effect. These results were discussed in terms of diffuse attention and contingent capture models of attention.