Phenomenology of Early Childhood Onset Obsessive Compulsive Disorder

This paper describes the phenomenological features of early childhood onset obsessive compulsive disorder (OCD; defined as children meeting DSM-IV criteria for OCD with age of onset <8 years). Fifty-eight children (ages 4–8) were included in the sample. OCD and comorbid diagnoses were determined by structured interview, and OCD severity was measured using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Mean age of OCD onset was almost five, and mean age of presentation was between 6 and 7. Mean symptom severity was in the moderately severe range. Comorbidity and family history of OCD were common. Contamination and aggressive/catastrophic obsessions and washing and checking compulsions were endorsed most frequently. Results indicate that early childhood onset OCD may have a lower boy to girl ratio and lower rates of depressive disorders, but may be similar to later childhood onset OCD in terms of OCD symptom presentation and severity.     

Examining the Psychometric Properties of the Family Accommodation Scale-Parent-Report (FAS-PR)

Growing research has examined parental accommodation among the families of children with obsessive-compulsive disorder (OCD). However, these studies have utilized a parent-report (PR) version of a measure, the Family Accommodation Scale (FAS) that has never received proper psychometric validation. In turn, previously derived subscales have been developed via clinical rather than empirical evidence. This study aims to conduct a comprehensive psychometric analysis of the FAS-PR utilizing data collected from 96 youths with OCD. Exploratory factors analysis was conducted and revealed a 12-item scale yielding two separate, yet related subscales, Avoidance of Triggers (AT) and Involvement in Compulsions (IC). Subsequent analyses revealed good internal consistency and convergent and discriminant validity. These findings suggest that future research should seek to examine factors that may impact various facets to accommodation as well as the role these facets plays in predicting treatment outcome. Limitations are discussed.     

Forgiveness,Reconciliation, and Mechila: Integrating the Jewish Concept of Forgiveness Into Clinical Practice

The professional literature diverges in defining the role of forgiveness and reconciliation in counseling regarding how forgiveness and reconciliation are conceptualized from a professional and secular perspective. The Jewish conceptualization of forgiveness is multifaceted; mechila, the forgiveness of debt, is particularly important in providing a framework for forgiveness when the issue of reconciliation is involved. The authors offer an explanation of the Jewish conceptualization of forgiveness and discuss a way to infuse the concept of mechila into counseling practice on a broader level with all clients.     

Memory issues pertaining to social marketing messages about behavior enactment versus non-enactment

This article examines efficiency issues pertaining to social marketing messages about behavior enactment (e.g., smoker) vs. non-enactment (e.g., nonsmoker). Building on a wealth of psycholinguistics research, we posit that underlying differences in the processing and storage of word concepts with affixal negations affect learning and memory for these concepts (i.e., associations with non-enactment concepts will be harder to learn and remember than associations with enactment concepts). Two experiments support our predictions, suggesting that messages about enactment will demonstrate superior efficiency. Implications of study findings are discussed in terms of possibilities for improving the efficiency of social marketing messages about non-enactment.     

Stimulation of the lateral geniculate,superior colliculus,or visual cortex is sufficient for eyeblink conditioning in rats

The role of the cerebellum in eyeblink conditioning is well established. Less work has been done to identify the necessary conditioned stimulus (CS) pathways that project sensory information to the cerebellum. A possible visual CS pathway has been hypothesized that consists of parallel inputs to the pontine nuclei from the lateral geniculate nucleus (LGN), superior colliculus (SC), pretectal nuclei, and visual cortex (VCTX) as reported by Koutalidis and colleagues in an earlier paper. The following experiments examined whether electrical stimulation of neural structures in the putative visual CS pathway can serve as a sufficient CS for eyeblink conditioning in rats. Unilateral stimulation of the ventral LGN (Experiment 1), SC (Experiment 2), or VCTX (Experiment 3) was used as a CS paired with a periorbital shock unconditioned stimulus. Stimulation was delivered to the hemisphere contralateral to the conditioned eye. Rats in all experiments were given five 100-trial sessions of paired or unpaired eyeblink conditioning with the stimulation CS followed by three paired sessions with a light CS. Stimulation of each visual area when paired with the unconditioned stimulus supported acquisition of eyeblink conditioned responses (CRs) and substantial savings when switched to a light CS. The results provide evidence for a unilateral parallel visual CS pathway for eyeblink conditioning that includes the LGN, SC, and VCTX inputs to the pontine nuclei.Pavlovian eyeblink (eyelid closure and nictitating membrane movement) conditioning is established by pairing a conditioned stimulus (CS), usually a tone or light, with an unconditioned stimulus (US) that elicits the eyeblink reflex. The eyeblink conditioned response (CR) emerges over the course of paired training, occurs during the CS, and precedes the US (Gormezano et al. 1962; Schneiderman et al. 1962). Neurobiological investigations of Pavlovian eyeblink conditioning have primarily focused on the cerebellum, which is the site of memory formation and storage (Thompson 2005). The anterior interpositus nucleus is necessary for acquisition and retention of the eyeblink CR (Lavond et al. 1985; Krupa and Thompson 1997; Freeman Jr. et al. 2005; Thompson 2005; Ohyama et al. 2006). Lobule HVI and the anterior lobe of the cerebellar cortex (lobules I–V) contribute to acquisition, retention, and timing of the CR (McCormick and Thompson 1984; Perrett et al. 1993; Perrett and Mauk 1995; Attwell et al. 1999, 2001; Medina et al. 2000; Nolan and Freeman Jr. 2005; Nolan and Freeman 2006). The brainstem nuclei that comprise the proximal ends of the CS and US input pathways to the cerebellum have also been identified.The pontine nuclei (PN) and inferior olive (IO) receive CS and US information, respectively, and are the primary sensory relays into the interpositus nucleus and cerebellar cortex (Thompson 2005). Conditioned stimulus information converges in the PN, which receives projections from lower brainstem, thalamus, and cerebral cortex (Glickstein et al. 1980; Brodal 1981; Schmahmann and Pandya 1989; Knowlton et al. 1993; Campolattaro et al. 2007). The lateral pontine nuclei (LPN) are the sources of auditory CS information projected into the cerebellum. Lesions of the LPN block CR retention to a tone CS, but have no effect on CRs to a light CS (Steinmetz et al. 1987). Thus, CS inputs from different sensory modalities may be segregated at the level of the PN. Neurons in the PN project CS information into the contralateral cerebellum via mossy fibers in the middle cerebellar peduncle that synapse primarily on granule cells in the cerebellar cortex and on neurons in the deep nuclei (Bloedel and Courville 1981; Brodal 1981; Steinmetz and Sengelaub 1992). Stimulation of the PN acts as a supernormal CS supporting faster CR acquisition than conditioning with peripheral stimuli (Steinmetz et al. 1986, 1989; Rosen et al. 1989; Steinmetz 1990; Tracy et al. 1998; Freeman Jr. and Rabinak 2004). The primary focus of these experiments was to investigate the most proximal components of the CS pathway in eyeblink conditioning. There has been less emphasis on identifying the critical CS pathways that project information to the PN.Recent studies using lesions, inactivation, stimulation, and neural tract tracing have provided evidence that the auditory CS pathway that is necessary for acquisition and retention of eyeblink conditioning is comprised of converging inputs to the medial auditory thalamic nuclei (MATN), and a direct ipsilateral projection from the MATN to the PN (Halverson and Freeman 2006; Campolattaro et al. 2007; Freeman et al. 2007; Halverson et al. 2008). Unilateral lesions of the MATN, contralateral to the conditioned eye, block acquisition of eyeblink CRs to a tone CS but have no effect on conditioning with a light CS (Halverson and Freeman 2006). Inactivation of the MATN with muscimol blocks acquisition and retention of CRs to an auditory CS, and decreases metabolic activity in the PN (Halverson et al. 2008). The MATN has a direct projection to the PN and stimulation of the MATN supports rapid CR acquisition (Campolattaro et al. 2007). Our current model of the auditory CS pathway consists of converging inputs to the MATN, and direct unilateral thalamic input to the PN (Halverson et al. 2008).Less work has been done to identify the visual CS pathway necessary for eyeblink conditioning. A possible parallel visual CS pathway has been hypothesized, which includes parallel inputs to different areas of the PN from the lateral geniculate nucleus (LGN), superior colliculus (SC), visual cortex (VCTX), and pretectal nuclei (Koutalidis et al. 1988). In the Koutalidis et al. study, lesions of the LGN, SC, VCTX, or pretectal nuclei alone had only a partial effect on CR acquisition with a light CS. Lesions of any two of these structures together produced a more severe impairment on acquisition and combined lesions of all of these areas completely blocked CR acquisition to a light CS (Koutalidis et al. 1988). Each visual area investigated in the Koutalidis et al. study has a direct projection to the PN that could be important for eyeblink conditioning. The ventral LGN projects to the medial, and to a lesser extent, the lateral PN (Graybiel 1974; Wells et al. 1989). The superficial, intermediate, and deep layers of SC send projections to both the dorsomedial and dorsolateral PN (Redgrave et al. 1987; Wells et al. 1989). The VCTX has a direct projection to the rostral and lateral portions of the PN (Glickstein et al. 1972; Baker et al. 1976; Mower et al. 1980; Wells et al. 1989). The pretectal nuclei also have a direct projection to both the medial and lateral PN (Weber and Harting 1980; Wells et al. 1989). However, stimulation of the anterior pretectal nucleus is not an effective CS for eyeblink conditioning (Campolattaro et al. 2007). The failure to establish conditioning with stimulation of the anterior pretectal nucleus as a CS suggests that there may be differences in the efficacy of the various visual inputs to the PN for cerebellar learning. The following experiments investigated the sufficiency of stimulation of the LGN, SC, or primary VCTX as a CS for eyeblink conditioning in rats.     

Screening for drugs in oral fluid: Illicit drug use and drug driving in a sample of urban and regional Queensland motorists

Police services in a number of Australian states and overseas jurisdictions have begun to implement or consider random road-side drug testing of drivers. This paper outlines research conducted to provide an estimate of the extent of drug driving in a sample of Queensland drivers in regional, rural and metropolitan areas. Oral fluid samples were collected from 2657 Queensland motorists and screened for illicit substances including cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamines, ecstasy, and cocaine. Overall, 3.8% of the sample (n = 101) screened positive for at least one illicit substance, although multiple drugs were identified in a sample of 23 respondents. The most common drugs detected in oral fluid were ecstasy (n = 53), and cannabis (n = 46) followed by amphetamines (n = 23). A key finding was that cannabis was confirmed as the most common self-reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs. drink driving detection rates for one region of the study, revealed a higher detection rate for drug driving (3.8%) vs. drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland roads, and may in fact be more common than drink driving. This paper will further outline the study findings’ and present possible directions for future drug driving research.     

Now you see me,now you don't: evidence that chimpanzees understand the role of the eyes in attention

Chimpanzees appear to understand something about the attentional states of others; in the present experiment, we investigated whether they understand that the attentional state of a human is based on eye gaze. In all, 116 adult chimpanzees were offered food by an experimenter who engaged in one of the four experimental manipulations: eyes closed, eyes open, hand over eyes, and hand over mouth. The communicative behavior of the chimpanzees was observed. More visible behaviors were produced when the experimenter's eyes were visible than when the experimenter's eyes were not visible. More vocalizations were produced when the experimenter's eyes were closed than when they were open, but there were no differences in other attention getting behaviors. There was no effect of age or rearing history. The results suggest that chimpanzees use the presence of the eyes as a cue that their visual gestures will be effective.     

Stimulus control of behavioral history.

Pigeons were exposed to two different reinforcement schedules under different stimulus conditions in each of two daily sessions separated by 6 hr (Experiments 1 and 2) or in a single session (Experiment 3). Following this, either a fixed-interval (Experiment 1) or a variable-interval schedule (Experiments 2 and 3) was effected in both stimulus conditions. In the first two experiments, exposure to fixed-ratio or differential-reinforcement-of-low-rate schedules led to response-rate, but not pattern, differences in subsequent performance on fixed- or variable-interval schedules that persisted for up to 60 sessions. The effects of reinforcement-schedule history on fixed-interval schedule performance generally were more persistent. In Experiment 3, a history of high and low response rates in different components of a multiple schedule resulted in subsequent response-rate differences under identical variable-interval schedules. Higher response rates initially occurred in the component previously correlated with high response rates. For 3 of 4 subjects, the differences persisted for 20 or more sessions. Previous demonstrations of behavioral history effects have been confined largely to between-subject comparisons. By contrast, the present results demonstrate strong behavioral effects of schedule histories under stimulus control within individual subjects.     

Single session treatment of a borderline personality disorder

Debbie, a patient in ongoing therapy, volunteered to assist in a workshop by participating in an interview. The goals of the session were to identify some small, discrete problem that could be worked on in the limited time available, and to demonstrate how a short-term treatment can be used.The issues considered revolved around Debbie's schema. Her early abuse set several schemas that have directed Debbie's life. The goals of the therapy would be to help modify those rules. The single session was a microcosm of a longer-term therapy. Overall, from the reports of the patient and her therapist, on follow-up, she was able to do the homework with the the therapist's assistance and found that it was helpful in countering the negative thoughts. This led to a lifting of the concomitant depression and a diminution in the self-injurious behavior.Many sessions would be needed to reinforce and strengthen the exercise strated in this session. Overall, I would see this session as both a successful treatment session and a demonstration of how identifying discrete, proximal goals can benefit patients with long-standing Axis II problems. The hypotheses and questions led to data gathering and hypothesis testing. Throughout the session, it was essential to be aware of the likely schemas so that some could be used in the session, while others were clearly avoided. By developing a conceptualization or model of the problem(s), a set of interventions could be mobilized within the session and as homework between sessions. By working toward a coping model of treatment rather than attempting to cure long-standing problems, brief cognitive behavioral interventions can be successful.     

Stability of the MCMI among depressed psychiatric outpatients

The Millon Clinical Multiaxial Inventory (MCMI) is a promising, yet somewhat unproven psychometric inventory developed to identify clinical syndromes and personality traits consonant with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The stability of its measures for both the theoretically more stable personality characteristics and the clinical syndromes was investigated in a group of depressed psychiatric outpatients. In this test-retest design with a 3-month interval between tests, clinical syndrome scales of relevance changed significantly as expected. However, many of the personality scales also changed significantly. Only four of the personality scales met a two-fold test of stability. Findings are discussed in terms of characteristics of self-report inventories such as the MCMI, the uniqueness of the depressed population, and characteristics of personality disorders.