Neuropsychological Aspects of Multiple Sclerosis

Since S. Rao's [Neuropsychology of Multiple Sclerosis: A Critical Review, A Journal of Clinical and Experimental Neuropsychology, Vol. 85, pp. 503–542] (1986) seminal review, considerable research has been undertaken on the neuropsychological consequences of multiple sclerosis. This review incorporates the research literature of the last decade in presenting an overview of the current state of our knowledge concerning the etiology, course, symptoms, assessment, consequences, and treatment of multiple sclerosis (MS). The concept of subcortical dementia is revisited in light of the most recent literature documenting the neuropsychological deficits in patients with MS. The view that cognitively heterogeneous patient groups may disguise more specific patterns of focal neuropsychological impairment is considered. A critical review of the recent literature is also presented, detailing the degree to which recent research has addressed the areas of research need identified by Rao in 1986. Given recent advances in our knowledge, the need for more attention to be directed toward the evaluation of rehabilitation and psychological intervention is highlighted.     

Poststroke depression: Prevalence,course, and associated factors

Despite the considerable amount of research that has been undertaken on poststroke depression, a review of the literature demonstrates that there are many inconclusive findings in the area. In particular, the causes and course of the disorder remain to be firmly established. While studies of prevalence differ with respect to the nature and timing of their assessment procedures, most conclude that poststroke depression has a negative impact on the rehabilitation of the stroke patient. Very little research is available on the relationship between poststroke depression and care-giver burden. However, recent studies have adopted more rigorous methodological procedures, allowing some insights into the complex mixture of factors which determine the occurrence of poststroke depression.     

Does intermodal equivalence exist between heteromodal stimulus dimensions or between stimulus values on those dimensions?

In a same--different judgement task with successively presented signals, subjects matched dots in different vertical positions and tones of different frequencies intramodally and intermodally. The first and second stimuli of trials in each of the four modality conditions were drawn from a set consisting of two, three or five alternatives. In all intermodal set size conditions, the dimensions of pitch and vertical position were related by the same equivalence rule. While intramodal performance improvement depended only on the total number of practice trials at matching on the relevant dimensions, intermodal performance improvement appeared to be related to the number of trials practice with each heteromodal stimulus pairing in a particular set. After performance had approached asymptotic level neither intramodal nor intermodal matching reaction time depended on set size. Mean “same” reaction time was less than mean “different” reaction time, and this difference was greater for intermodal matching than for intramodal matching. The results indicated that intermodal equivalence exists between discrete stimulus values on heteromodal dimensions rather than between the dimensons themselves.     

The recovery of a visually masked target

Ss were briefly shown pairs of letters under backward masking and disinhibitive backward masking conditions. For the backward masking condition, a single homogeneous flash of light (M1), varying in duration, followed the presentation of letters after a varying delay (IS11), and recognition of the target letters (TS) was found to be a function of M1 duration and ISI1. For the disinhibition condition, a variable second mask (M2) followed M1 after a variable delay (ISI2) and disinhibition of M1’s effect on TS recognition occurred. Provided the ISIs were adequate, a relatively powerful M2 wass found to disinhibit a moderate Ml’s effect on the TS. Current theories of visual masking were examined in the light of these findings.     

Women's Dress Fashions as a Function of Reproductive Strategy

Despite many speculations, there is no well-supported explanation for cycles of fashion in.women's dress and scholars cannot agree whether fashions reflect societal changes. Generalizing from cycles of bodily attractiveness for women, it was hypothesized that dress styles are reflective of reproductive economics. Using data from three studies of dress fashion extending from 1885-1976, the prediction was tested thatshortskirts (signaling sexual accessibility) would be correlated with low sex ratios (indicating limited marital opportunity for women), with increased economic opportunities for women and with marital instability. Predictions for narrowwaists and low necklines (which signal reproductive value) were opposite. These predictions received strong support indicating that dress styles, like standards of bodily attractiveness may be partly determined by marital economics.     

Iontophoretically applied potassium ions as an experimental pain stimulus for investigating pain mechanisms

The present study investigated the psychophysical characteristics of potassium iontophoresis and its suitability as an experimental pain stimulus. Experiment 1 investigated the optimal duration of the pain stimulus for reliable reporting across repeated trials and whether the relationship between stimulus and subject response was linear, logarithmic, or a power function. In Experiment 2, the optimal interstimulus interval (ISI) was determined for reliable pain reporting, and stimulus history effects, both in terms of session effects and the effects of immediately preceding stimuli, were evaluated. In Experiment 3, potassium iontophoresis was compared with a sodium iontophoresis control. Linear functions described the stimulus-pain relationship best. No significant differences in the goodness-of-fit coefficients of determination, correlations, or coefficients of variation were found for the stimulus durations of 1, 2, and 4 sec. Significant stimulus history effects were found across a session, with adaptation and enhancement of responding for low- and moderate-intensity stimuli, respectively. The effects of the immediately preceding stimuli were suppression or enhancement of pain response, depending on the ISI, the preceding stimulus intensity, and the present stimulus intensity. Potassium iontophoresis was a significantly more effective pain stimulus than was sodium iontophoresis. It was concluded that potassium iontophoresis is a convenient and reliable experimental pain stimulus, which can be presented rapidly and repeatedly with minimal loss in consistency of subject pain report. Potassium iontophoresis provides a tool for investigating the neural modulation of pain in the relative absence of inflammation processes and tissue damage.     

Student mental health: how can psychiatrists better support the work of university medical centres and university counselling services?

Student psychiatric morbidity is rising. Whilst the influence of university counselling services is widely reported, NHS involvement by psychiatrists and general practitioners is not so well described. Counselling and mental health service providers for students at the University of Leeds were approached for numerical data and a university Group on Student Mental Health discussed the findings. The Student Counselling Centre, the University Medical Practice and a dedicated student psychiatric clinic have all seen a rise in referral rates. The University Medical Practice has also seen a rise in the prescribing of psychoactive medication. Collaborative links at the University of Leeds are explored and options for the future discussed. These include self-help over the internet, a research project to assess student mental health needs and the provision of a dedicated NHS psychiatric team for the university.