Status of perfusion scintigraphy in the diagnostic strategy in cerebrovascular disorders and space-occupying lesions

The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalised neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuraty of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of the patients had no influence on the results as a whole. Compared with contrast-medium angiography, incorrect diagnosis must be expected in 17% of the cases. This includes erroneous negative findings in 10% of the cases. Grounds for misinterpretations are suggested, and the biological and methodological limitations of the method are set forth.     

A view of aggression in phobic states

This article attempts to apply a theory of aggression as motivation to overcome obstacles to the understanding of phobic states and their formation. The role of aggression in the genesis of phobic conditions is discussed, and the traditional analytic view of aggression as instinctual drive is contrasted with a motivational approach. The motivational view offers the advantage of a clearer understanding of the stimulus contexts, representational connections, and both real and imaginary object connections that are lacking in the more traditional understanding of aggression as a biological drive.     

Structural differentiation of psychological performances in epilepsy patients

Investigating the specific of psychic performance disorders in epileptics structural aspects in addition to quantitative performance differences are considerable. We compared psychometrically obtained performance structures of epileptic children and adults and of parallelised healthy control persons. It became evident, that the performance differentiation hypothesis is to corroborate also in epileptic patients. The psychic performance structure of epileptics is characterized by a lower differentiation level of the basis functions underlining the performances. Our factor analytic investigations emphasize the importance of deceleration of psychic/psychomotoric speed in epileptics as primary basic disorder.     

Intrathecal methotrexate--overdosing in pediatric lymphoblastic leukemia

Intrathecal methotrexate-overdosage in the meningosis therapy leads to CNS damages dependent on dose. It was given a own case report and a literature review with clinical symptoms and the therapy in this complication. Neuropathologic findings included demyelinisation und necrosis of the white matter.     

Interpretation of paroxysmal slow activity--"subcortical signs"--in the electroencephalography of adults

Slow paroxysmal EEG activity, also referred to as "subcortical signs", offers an indication of impaired subcortico-cortical functional interaction that may be set off as a result of intracranial processes of a wide range of localisation. For this reason, the occurrence of this EEG pattern should not be taken to indicate a primary localisation in the range of the medical subcortical structures, nor does its absence imply any improbability of extensive lesions in the region. Taking into consideration the form and frequency of the waves during paroxysms and their local distribution, even this aspecific pattern yields more information for the clinical diagnosis. In particular, generalised paroxysms from monomorphic delta waves are usually associated with an existing primary or secondary brain illness, and would suggest the need for further diagnostic clarification. In interpreting the slow-wave groups restricted to the temporal regions, frequently counted among the "subcortical signs", the wave frequency and the patient's age must be taken into account. In the second half of life they frequently occur unaccompanied by any pathological process.     

Identity conflict in Mexican-American adolescents

Mexican-American adolescents of migrant origin present conflicting attitudes in their selection of ideal characters and images for identification. As minority members, identification with members of outside groups appears blocked for them. At the same time, encounters with outside society seem to undermine identification processes that develop within their own group, their families, and community. This study concludes that relationships of dominance and dependence in the outside society foster inhibitions to the process of identification, and disturbances in the mechanisms of defense in the minority member. These relationships seem to interfere with the internalization and adoption of significant others' characteristics and attitudes.     

A preliminary report on defenses and conflicts associated with borderline personality disorder

The authors present preliminary psychodynamic findings from a naturalistic study of borderline personality disorder compared to antisocial personality disorder and bipolar type II (depression with hypomania) affective disorder. An independent psychodynamic interview of each subject was videotaped from which ratings were made of the presence of 22 defense mechanisms and 11 psychodynamic conflicts. A factor analysis of ratings from 81 subjects supported the separation of borderline (splitting, projective identification) from narcissistic defenses (devaluation, omnipotence, idealization, mood-incongruent denial). While certain groups of defenses were associated with each diagnosis, defense ratings did not significantly discriminate the three diagnostic groups, suggesting a limit to their diagnostic value. Among 27 subjects rated, borderline personality was strongly associated with two conflicts: separation-abandonment, and a global conflict over the experience and expression of emotional needs and anger. Antisocial personality was psychodynamically distinct and more heterogeneous. Bipolar type II was associated with two hypothesized depressive conflicts: dominant other and dominant goal. Chronic depression, which was more common in both personality disorder groups than in bipolar type II, was associated with a third depressive conflict, overall gratification inhibition. Overall, conflicts were powerful discriminators of the three diagnostic groups. The heuristic value of these findings is discussed.     

A factor analytic study of manifest anxiety: a transsituational, transtemporal investigation

In this study, we investigated the factorial structure of the Manifest Anxiety Scale (MAS) among American, counseling graduate students (N = 227). The MAS was administered across transsituational and transtemporal conditions. The following four factors were yielded following orthogonal rotation: General Worries, Physiological Correlates of Anxiety, Distractibility, and Embarrassment. These four factors, however, explained less than one quarter of the common variance extracted. Following a comparison with previous factor analytic studies of the MAS, we discuss factors possibly contributing to the discrepant findings, with particular attention to the MAS's item content and psychometric properties and the nature of the population used.     

Altruism and aggression: the heritability of individual differences

Five questionnaires measuring altruistic and aggressive tendencies were completed by 573 adult twin pairs of both sexes from the University of London Institute of Psychiatry Volunteer Twin Register. The questionnaires measured altruism, empathy, nurturance, aggressiveness, and assertiveness. The intraclass correlations for the five scales, respectively, were .53, .54, .49, .40, and .52 for 296 monozygotic pairs, and .25, .20, .14, .04, and .20 for 179 same-sex dizygotic pairs, resulting in broad heritability estimates of 56%, 68%, 70%, 72%, and 64%. Additional analyses, using maximum-likelihood model-fitting, revealed approximately 50% of the variance on each scale to be associated with genetic effects, virtually 0% with the twins' common environment, and the remaining 50% with each twins' specific environment and/or error associated with the test. Correcting for the unreliability in the tests raised the maximum-likelihood heritabilities to approximately 60%. Age and sex differences were also found: altruism increased over the age span from 19 to 60, whereas aggressiveness decreased, and, at each age, women had higher scores than men on altruism and lower scores on aggressiveness.