Selective impairment of phonation: A case study

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.     

Comprehension of sentence structure in anomic and conduction aphasia

Picture-pointing auditory and reading comprehension tests were administered to anomic and conduction aphasics. Subjects responded to active sentences of the present progressive form. The possible errors which a subject could make on these experimental tasks included failure to correctly interpret noun order, number, or lexical meaning. Both groups made significantly more correct responses than error responses. Of their error responses, noun-order errors significantly exceeded number and lexical errors for which no differences were observed. When compared with results previously obtained for agrammatic Broca's aphasics, no differences in the pattern of errors were identified. These results are discussed relative to current theories of syntactic processing and for the mechanisms which account for these syntactic comprehension deficits following aphasia.     

Powers, causation, and modality

A complex theory concerning powers, natures, and causal necessity has emerged from the writings of P. H. Hare, E. H. Madden, and R. Harré. In the course of rebutting objections that other critics have raised to the power account of causation, I correct three of its genuine difficulties: its attempt to analyze power attributions in terms of conditional statements; its characterization of the relation between something's powers and its nature; and its doctrines concerning conceptual necessity. The resulting interpretation of causal modalities is then subsumed under a more general power account of modality, related at a number of points to considerations concerning powers, and further illustrating their philosophical importance.     

Knowledge and beliefs regarding the consequences of cigarette smoking and their relationships to smoking status in a biracial sample

The purpose of this investigation was to evaluate carefully smoking-related knowledge and beliefs and their relationships to smoking status in a large, heterogeneous sample of smokers and nonsmokers in two settings: (a) a large, biracial southern city and (b) a small midwestern community. Participants were 611 (198 male, 413 female) adult respondents to a random-dialing telephone survey in Fargo, North Dakota (n = 200), and Memphis, Tennessee (n = 411). Each participant was given the Smoking Attitudes Survey, which assesses generalized health beliefs as well as health-related problems associated with smoking. Participants' knowledge of smoking-associated diseases (e.g., lung cancer) and of diseases not associated with smoking (e.g., kidney stones) was assessed. Stepwise regression analysis of composite knowledge scores revealed four independent predictors of the health consequences of smoking: education, race, smoking status, and income. Smokers, compared to nonsmokers, reported less knowledge related to the health consequences of smoking, were more likely to be male, were less concerned with the health consequences of smoking, and were more concerned about the health consequences of cholesterol. The best predictor of smokers who had never attempted cessation was their greater concern over weight control when compared to smokers with a history of smoking cessation attempts. The results are discussed in terms of smoking prevention and intervention efforts.     

Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.     

Contextually relevant aspects of meaning

A series of six experiments investigated whether inferences about contextually relevant aspects of meaning were encoded into memory during reading. In all the experiments, subjects studied short paragraphs. Then, test sentences were presented that expressed relevant aspects of meaning that had not been explicitly stated in the paragraphs. For example, for a paragraph about searching for the correct color to paint a picture of a tomato, a relevant aspect of meaning would be that tomatoes are red. The test sentences were presented either immediately following the relevant paragraph or after a delay. With immediate testing, it was argued that the facilitation obtained in verification latency could result from processes occurring either when the context was read or when the test sentence was verified. With delayed testing, evidence was found to support the hypothesis that contextually relevant aspects of meaning are incorporated into the memory representation of the paragraph, but such evidence was obtained only when the retrieval environment encouraged the use of newly learned information in the decision process on the test sentence.     

A cost-benefit analysis of demand for food.

Laboratory studies of consumer demand theory require assumptions regarding the definition of price in the absence of a medium of exchange (money). In this study we test the proposition that the fundamental dimension of price is a cost-benefit ratio expressed as the effort expended per unit of food value consumed. Using rats as subjects, we tested the generality of this "unit price" concept by varying four dimensions of price: fixed-ratio schedule, number of food pellets per fixed-ratio completion, probability of reinforcement, and response lever weight or effort. Two levels of the last three factors were combined in a 2 x 2 x 2 design giving eight groups. Each group was studied under a series of six FR schedules. Using the nominal values of all factors to determine unit price, we found that grams of food consumed plotted as a function of unit price followed a single demand curve. Similarly, total work output (responses x effort) conformed to a single function when plotted in terms of unit price. These observations provided a template for interpreting the effects of biological factors, such as brain lesions or drugs, that might alter the cost-benefit ratio.     

Religion,Type A behavior,and health

In a study of air traffic controllers, religious differences are found in the way Type A behavior is associated with several health status indicators. Associations between the Jenkins Activity Survey (JAS) and physical illness incidence, health-promotive behavior, diastolic and systolic blood pressure, subjective distress and impulse control problems, and alcohol consumption are examined by religious attendance, religious affiliation, and change in affiliation. Findings confirm that Type A does not vary significantly by religion. However, there are several significant findings between Type A and various health indicators. Type A is associated with illness incidence, overall and more strongly in several religion, subgroups. Type A and alcohol consumption are related positively in Protestants and converts, and negatively in churchgoing Catholics. Type A is related to impulse control problems in churchgoing Protestants and to subjective distress in churchgoing Catholics. Finally, in individuals with weak or no religious ties, Type A is associated with lower blood pressure. This last finding suggests that in some people (for example, the irreligious or unchurched), the coronary-prone behavior pattern may have cardiovascular effects which are salutary in at least one respect.The authors wish to thank Dr. Kyriakos S. Markides and Laura A. Ray for their assistance with this study. Address requests for reprints to Dr. Levin at the Institute of Gerontology, 300 North Ingalls, Ann Arbor, MI 48109.