Effectiveness and safety of epilepsy surgery: what is the evidence?

Evidence from a recent randomized controlled trial of surgical versus medical therapy of temporal lobe epilepsy proves that antero-mesial resection is safe and more effective than medical therapy. The number of patients needed to treat for one patient to become free of disabling seizures is two, which is superior to most interventions in neurology. A meta-analysis of non-randomized trials gives almost identical results; about two-thirds of patients become seizure-free, compared with only 8% with medical therapy. The results are remarkably similar among studies from different parts of the world. Quality of life improves early after epilepsy surgery, the improvements are both statistically and clinically significant, and they are sustained. Surgical morbidity with clinically important permanent sequelae is 2%. Epilepsy surgery remains underutilized in developed countries and it does not exist in all but a few developing countries. Current randomized trials are underway to explore the effect of early surgery versus optimum medical therapy on the prevention of disability in patients with mesial temporal lobe epilepsy, and to examine the effectiveness of novel interventions, such as minimally invasive surgery and brain stimulation.     

Maternal regulation of infant reactivity from 2 to 6 months

Previous research has investigated the effect of maternal soothing behaviors on reducing infant reactivity but not the differential effects of specific maternal behaviors on infant stress responses. The present study investigated maternal regulation of 2- and 6-month-olds' responses to an inoculation and found a significant decline with age in both the intensity and duration of infants' crying. Maternal affection and touching decreased from 2 to 6 months, whereas maternal vocalizing and distraction behaviors increased. At both ages, the combination of maternal holding/rocking and vocalizing was associated with decreases in all levels of infant reactivity. Neither strategy alone, however, was found to be effective. Feeding/ pacifying behaviors were effective only when initial distress was at a low or moderate level, which suggests that the effectiveness of maternal regulatory behaviors may depend on the intensity of infants' crying.     

Shyness: relationship to social phobia and other psychiatric disorders

The relationship between shyness, social phobia and other psychiatric disorders was examined. The prevalence of social phobia was significantly higher among shy persons (18%) compared with non-shy persons (3%). However, the majority of shy individuals (82%) were not socially phobic. A significant and positive correlation was found between the severity of shyness and the presence of social phobia, but the data suggest that social phobia is not merely severe shyness. Social phobia was also positively and moderately correlated with introversion and neuroticism. Thus, shy persons with social phobia were shyer, more introverted, and more neurotic than other shy people, but none of these factors was sufficient to distinguish shy persons with social phobia from those without social phobia. The proportion of the shy group with psychiatric diagnoses other than social phobia was significantly higher than among the non-shy group, indicating that various diagnostic categories are prominent among the shy. The results are discussed in terms of the overlap in shyness and social phobia and the relationship of shyness to other psychiatric diagnoses and personality dimensions.     

A dog's got personality: a cross-species comparative approach to personality judgments in dogs and humans

This research offers a blueprint for how a cross-species comparative approach can be realized empirically. In a single design, parallel procedures and instruments were used in 2 species, dogs (Canis familiaris) and humans (Homo sapiens), to test whether personality differences exist and can be judged in dogs as accurately as in humans. Personality judgments of humans and dogs were compared on 3 accuracy criteria: internal consistency, consensus, and correspondence. Results showed that, on all 3 criteria, judgments of dogs were as accurate as judgments of humans. These findings are consistent with the evolutionary continuity hypothesis and suggest an important conclusion not widely considered by either personality or animal researchers: Personality differences do exist and can be measured in animals other than humans.     

Experimental tests of an attitudinal theory of the gender gap in voting

This research examined the hypothesis that gender gaps in voting stem from differences in the extent to which men and women agree with candidates' issue stances. Two initial experiments portraying candidates by their sex and attitudes and a third experiment that also included information about political party produced the predicted attitudinal gender-congeniality effect: Participants of each sex reported greater likelihood, compared with participants of the other sex, of voting for the candidate who endorsed positions typically favored more by their own sex than the other sex. In addition, this gender-congeniality effect was present among Republican and independent participants but absent among Democratic participants because Democratic men as well as women favored candidates who advocated the positions typically favored by women. Interpretation invoked the importance of group interest based on gender as an influence on women's voting.     

Divergent ethical perspectives on the duty-to-warn principle with HIV patients

This article presents the case of an HIV-positive client who reported having sexual relations with an unknowing partner. The issue raised is whether the therapist was required to warn the unknowing partner, similar to the Tarasoff mandate that is imposed on therapists. The case is analyzed from an ethical framework similar to that presented by Beauchamp and Childress (1994). Two opinions are presented, each leading to different conclusions about whether the therapist should inform the unknowing partner. It is concluded that although such analysis is valuable in aiding the therapist in his or her decision-making process, no clear professional standard for the management of the problem is evident.     

Enhanced retention in the passive-avoidance task by 5-HT(1A) receptor blockade is not associated with increased activity of the central nucleus of the amygdala

The effect of blockade of 5-HT1A receptors was investigated on (1). retention in a mildly aversive passive-avoidance task, and (2). spontaneous single-unit activity of central nucleus of the amygdala (CeA) neurons, a brain site implicated in modulation of retention. Systemic administration of the selective 5-HT1A antagonist NAN-190 immediately after training markedly-and dose-dependently-facilitated retention in the passive-avoidance task; enhanced retention was time-dependent and was not attributable to variations in wattages of shock received by animals. Systemic administration of NAN-190 had mixed effects on spontaneous single-unit activity of CeA neurons recorded extracellularly in vivo; microiontophoretic application of 5-HT, in contrast, consistently and potently suppressed CeA activity. The present findings-that 5-HT1A receptor blockade by NAN-190 (1). enhances retention in the passive-avoidance task, and (2). does not consistently increase spontaneous neuronal activity of the CeA-provide evidence that a serotonergic system tonically inhibits modulation of retention in the passive-avoidance task through activation of the 5-HT1A receptor subtype at brain sites located outside the CeA.     

Case Report—Loyalty, Legacy, and Ledger: Contextual Therapy in a Patient with a Family History of Ovarian Cancer

A client's emotional experiences and reactions to those experiences are influenced by his/her family of origin and direct or indirect interactions with various family members. Contextual therapists propose that a client's satisfaction with a relationship depends on the equity of his/her emotional interactions with family members. When relationships are inequitable, trust between individuals disintegrates. In order to reestablish trust in a relationship, a balance of interests must be restored. If not, imbalances may be passed down to future generations. A case of a woman with a family history of ovarian cancer is reviewed with the principles of contextual therapy in mind. In her family, several legacies have resulted in unbalanced relationships between family members that lead to difficulty in establishing trust within the genetic counseling session.     

Picture naming deficits in developmental dyslexia in German

Recent research with English developmental dyslexics comparing the picture naming performance of these children to the picture naming performance of non-dyslexic (‘garden variety’) poor readers, reading age matched controls and chronological age matched controls has suggested that a selective difficulty in retrieving the phonological codes of known names on demand underlies the picture naming deficit found in developmental dyslexia (Swan & Goswami, Picture naming deficits in developmental dyslexia: the phonological representations hypothesis, Brain and Language, 56 (1997), 334–353). If the underlying causal factors in dyslexia are independent of the orthography that the child is learning to read, then a difficulty in retrieving the phonological codes of known names on demand should also be found in developmental dyslexics who are learning to read other languages. We therefore set out to replicate Swan and Goswami’s study with a group of German developmental dyslexics. We were interested to see whether a phonological deficit is characteristic of dyslexia in all orthographies, even those, such as German, in which high orthographic transparency means that dyslexic children read with considerable accuracy.