Treatment with medications affecting dopaminergic and serotonergic mechanisms: effects on fluency and anxiety in persons who stutter

Medications with dopamine antagonist properties, such as haloperidol, and those with serotonin reuptake inhibitor properties, such as clomipramine, have been shown to improve fluency. To examine the degree to which each of these two pharmacological mechanisms might independently affect fluency, a selective serotonin reuptake inhibitor, paroxetine, and a selective dopamine (D-2) antagonist, pimozide, were evaluated. Both types of medications also affect mood and anxiety, factors that could influence fluency levels. Therefore, we also evaluated the medications’ effects on generalized and speech-related anxiety and the relationships between changes in anxiety and changes in fluency in 11 subjects with a history of developmental stuttering. The randomized, double blind, placebo-controlled crossover study that was designed had to be terminated prior to completion due to severe side effects following withdrawal from paroxetine. Even with a reduced sample size (n = 6), significant improvement in percent fluent speaking time (p = 0.02) was found using a telephone task between baseline and pimozide (n = 6), with average duration of dysfluencies significantly shorter (p = 0.04) but no significant difference in the estimated number of dysfluencies per minute. This significant improvement was associated with non-significant increases in generalized anxiety, but non-significant decreases in speech-related anxiety. No significant differences were found in fluency between baseline and paroxetine (n = 5). These preliminary results suggest that fluency improvement is more likely to be mediated by dopaminergic rather than serotonergic mechanisms. Due to its side effects, however, pimozide may be considered a risk for treatment of stuttering.

Educational objectives: As a result of reading this paper the reader will describe and explain: (1) how medications may affect fluency and the rationale for selecting medications for treatment trials; (2) the interrelationship between fluency and anxiety; and (3) factors important in developing clinical trials using medications.     

Access to Child and Adolescent Mental Health Services

Adequate access to child and adolescent mental health services for young people in high need populations is an important concern of service systems researchers and program evaluators. We present results of a statewide study of access to community mental health services for eight populations of special concern. The analysis relied exclusively on existing databases in conjunction with innovative statistical techniques to provide comprehensive measures of access to care. Our findings indicate that access to care varied substantially across special populations, although children and adolescents in each of our eight “special populations” had greater access to public mental health services than members of the general population of the state. The interpretation of the findings and directions for future research are discussed.     

Relative contributions of perceived mattering to parents and friends in predicting adolescents' psychological well-being

Perceived mattering is the psychological tendency to perceive the self as significant to specific other people. The central goal of this study was to examine whether adolescents' perceived mattering across social spheres (parents and friends) is addtive or compensatory in predicting adolescents' psychological well-being. Tests of the relative importance of adolescents' perceived mattering to parents and friends for psychological well-being were conducted using data from two convenience samples. Study 1 participants were, on the average, 17.5 yr. old and living in rural northwestern United States (N=128, 50% male, n=64; 50% female, n=64). Study 2 participants, on the average, were 16.9 yr. old, from a suburban western Canadian region (N=532, 51.4% male, n=273; 48.6% female, n=259). Hierarchical regression analysed with indicators of self-concept and behavioral misconduct as dependent variables used perceived mattering to parents and perceived mattering to friends and the interaction between these two variables as independent variables. Perceived mattering in both social spheres seemed the optimal condition for adolescents. Perceived mattering to friends "added" to perceived mattering to parents in explaining variance in assessments of psychological well-being in both studies.     

Religious involvement and the forgiving personality

The relationship between religious involvement and forgiveness was assessed in three samples of Western Europeans living in a social environment dominated by the Catholic tradition. The samples comprised nonbelievers/nonattendees, believers/nonattendees, believers/regular attendees, and religious people. Age and religious involvement were shown to affect the willingness to forgive in an interactive way: The effect of religious involvement was stronger for the elderly group. We also found that what made the difference in the willingness to forgive was mainly the social commitment to religion (attendance in church and the taking of vows), not mere personal beliefs. In addition, age and religious involvement were found to affect blockage towards forgiveness in an additive way.     

Identifying the Null Subject: Evidence from Event-Related Brain Potentials

Event-related brain potentials (ERPs) were recorded during spoken language comprehension to study the on-line effects of gender agreement violations in controlled infinitival complements. Spanish sentences were constructed in which the complement clause contained a predicate adjective marked for syntactic gender. By manipulating the gender of the antecedent (i.e., the controller) of the implicit subject while holding constant the gender of the adjective, pairs of grammatical and ungrammatical sentences were created. The detection of such a gender agreement violation would indicate that the parser had established the coreference relation between the null subject and its antecedent. The results showed a complex biphasic ERP (i.e., an early negativity with prominence at anterior and central sites, followed by a centroparietal positivity) in the violating condition as compared to the non-violating conditions. The brain reacts to NP-adjective gender agreement violations within a few hundred milliseconds of their occurrence. The data imply that the parser has properly coindexed the null subject of an infinitive clause with its antecedent.     

The stability of resting metabolic rate and diet-induced thermogenesis in children

The stability of resting metabolic rate and diet-induced thermogenesis was assessed in a group of 8- to 12-year-old children over two sessions. Children were first oriented to the laboratory and participated in a practice session to adapt them to the laboratory procedures. The two metabolic sessions began with the measurement of resting metabolic rate. The children were then provided a caloric challenge, with metabolic measures taken at 30-min intervals for 150 min. Results showed stable resting and integrated diet-induced thermogenic responses across sessions. Differences in the pattern of response from 30 to 60 min were observed, with the response peaking earlier in the first session.This experiment was supported in part by Grant HD19532 NICHD awarded to the first author.     

Cognitive correlates of depressive symptoms in 11-year-old children

Self-reports of depressive symptoms were obtained for 792 11-year-old New Zealand children using a structured interview. The aim of the present study was to test the hypothesis that depressive symptomatology in children is associated with impairment on cognitive tasks. The results did not support this hypothesis. Depression was unrelated to performance on various subscales of the WISCR, whereas self-reported inattention was associated with poor performance. Depressive symptoms, however, were significantly related to lower self-esteem and a poorer self-perception of scholastic ability.The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Medical Research Council of New Zealand and the Departments of Education and Health, and involves several departments of the University of Otago. Much of the data are gathered by voluntary workers from the Dunedin community. The authors are indebted to the many people whose contributions make this ongoing study possible.     

Sexual harassment of university students

The sexual harassment of junior, senior, and graduate student women and men by male and female professors, graduate assistants, and staff was investigated to determine students' personal experiences in the classroom, outside the classroom, and in job-related settings. Usable survey responses were returned by 393 students, and incidents were detailed by 38 women and 9 men who noted their responses to the harassment and its effects. Attitudes toward and acceptance of sexually harassing behaviors were measured by a 10-item Tolerance for Sexual Harassment Inventory (TSHI). The frequency of initiation of sexual behaviors was also assessed. More women than men reported being sexually harassed. Male and female perceptions of classroom behaviors were in agreement for most items. Men and women differed significantly on the TSHI, with men more tolerant of sexual harassment than women, and highly significant age differences were found, indicating a greater acceptance of sexual harassment by younger students. There was little difference between male and female students in the frequency of their initiating sexual behaviors. The TSHI was assessed; reliability coefficients and a factor analysis are presented.This research was supported by a grant from the College of Arts and Sciences. We are grateful to Betty Jones and Joan Bentley for their secretarial assistance.     

Workplace Integrity: Differences in Perceptions of Behaviors and Situational Factors

Pre-employment integrity tests assume differences between honest and dishonest individuals in their perceptions of the degree of dishonesty of given behaviors. This exploratory study investigated whether individuals classified as dishonest by an overt integrity test had different perceptions of the honesty of behaviors than those classified as honest. Differences in perceptions of situational factors promoting or deterring honesty were also examined. Dishonest individuals had different perceptions of behaviors and situations than honest individuals, suggesting that the relative influence of situational interventions may vary with the general integrity of a workforce.