The obsessive compulsive spectrum: a survey of 800 practitioners

The obsessive-compulsive (OC) spectrum is a group of related disorders that appear to share symptomatology, neurobiology, and treatment response with obsessive-compulsive disorder. To collect data on the appreciation of the OC spectrum concept among clinicians, 800 participants completed a questionnaire to help determine their understanding and appreciation of this concept, at a workshop on the OC spectrum.     

A nonparametric test for the two-sample problem

Moses [3] has proposed a nonparametric test of the null hypothesis that two samples, say a treatment and a control group, have been drawn from the same population; his test is designed to be sensitive to the alternative hypothesis that the treatment group is extreme in either or both directions as compared with the controls. This paper presents a test of similar character, except that rather than being based on a range of the control group ranks, it depends upon the variance of those ranks. This has the advantage of making ties less troublesome. Tables of significance values are presented for some small sample sizes. A normal approximation is developed and seen to be useful.This research was partially sponsored by a Public Health Biostatistics Training Grant at Stanford University.I wish to thank Professor Lincoln E. Moses of Stanford University for suggesting the problem, and for his invaluable assistance in the preparation of this paper.     

Self-enhancement among high-exposure survivors of the September 11th terrorist attack: resilience or social maladjustment?

The authors examined self-enhancing bias as a predictor of adjustment among individuals in or near the World Trade Center during the September 11, 2001, terrorist attacks. Resilience was defined from categorical and continuous analyses of both participant self-report and friend and relative ratings of adjustment. Self-enhancement was associated with a resilient outcome, ratings of better adjustment prior to September 11th, greater positive affect, and reduced perceptions of social constraints. Additional analyses indicated that self-enhancers' reduced symptom levels were fully mediated by their low perceived social constraints. However, consistent with previous evidence suggesting a social cost to self-enhancement, at 18 months post-September 11th, self-enhancers' friends and relatives also rated them as decreasing in social adjustment and as being less honest.     

A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention deficit/hyperactivity disorder

Mixed amphetamine salts extended release (MAS XR; Adderall XR) and atomoxetine (Strattera) were compared in children 6 to 12 years old with attention deficit/hyperactivity disorder (ADHD) combined or hyperactive/impulsive type in a randomized, double-blind, multicenter, parallel-group, forced-dose-escalation laboratory school study. Primary efficacy measure was the SKAMP (Swanson, Kotkin, Agler, M-Flynn, and Pelham) behavioral rating scale. Changes in mean SKAMP deportment scores from baseline were significantly greater for MAS XR (n = 102) than for atomoxetine (n = 101) overall (-0.56 and -0.13, respectively; p < .0001) and at each week (p < .001). Adverse events were similar for both treatment groups. The extended time course of action and greater therapeutic efficacy of MAS XR suggests that it is more effective than atomoxetine in children with ADHD.     

Comorbidity in compulsive hoarding: a case report

A 56-year-old male presented with compulsive hoarding along with attention-deficit/hyperactivity disorder and schizotypal personality disorder. Hoarding has been described as difficult to treat both pharmacologically and behaviorally, and this patient's comorbid conditions also contributed to his overall impairment. The patient's treatment regimen of fluvoxamine, amphetamine salts, and risperidone, along with behavioral therapy, has helped with hoarding behaviors, motivation, procrastination, and increased socialization. Hoarding may be a unique subtype of obsessive-compulsive disorder with poorer prognosis and distinct neuroanatomic dysfunction. Augmentation with stimulants may provide benefits in aspects of hoarding such as procrastination, especially in patients with comorbid attention-deficit hyperactivity disorder.     

Impact of recent findings on study design of future autism clinical trials

There are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.     

Effects of the periodic administration of odor or vibration on a 3-hr. vigilance task

The present study examined performance during 3 hr. of simulated sentry duty with and without the intermittent administration of low-level sensory stimuli (odor or vibration). For odor and control conditions, target-detection latency increased steadily over the course of the 3-hr. session. Administration of a tactile stimulus reduced the increase in detection latency compared to that found in odor and control conditions. For all conditions, there were no significant differences in target-detection frequency, shot accuracy, or friend-foe discrimination. Across all conditions, restlessness (motor activity) increased significantly the first hour and remained elevated for the rest of the session. Subjective measures of workload (NASA-TLX) indicated that the 3-hr. task rated high on physical demand, mental demand, frustration, and overall workload. These findings suggest that the intermittent delivery of a clearly detectable tactile stimulus can reduce reaction-time decrements that occur as time on task increases.     

Sex, sexual orientation, and identification of positive and negative facial affect

Sex and sexual orientation related differences in processing of happy and sad facial emotions were examined using an experimental facial emotion recognition paradigm with a large sample (N = 240). Analysis of covariance (controlling for age and IQ) revealed that women (irrespective of sexual orientation) had faster reaction times than men for accurate identification of facial emotion and were more accurate in identifying male faces than female ones, whereas men performed the same regardless of the sex of the face. However, there were no overall sex differences in accuracy. These findings suggest a limited role for sex in the perception of facial affect.