Screening for Medical and Neurodevelopmental Disorders for the Professional Counselor

This article reviews several assessment factors useful identifying the presence of a possible medical illness or neurodevelopmental disorder contributing to a client's adjustment problems. Use of behavioral observations, record reviews, brief neuro-behavioral screening tests, and the taking of a history are outlined that can assist in raising the index of suspicion for organic influence. Also addressed are issues pertaining to referral for medical and specialty assessments, including neuropsychological evaluation.     

FDG-PET analysis and findings in amnesia resulting from hypoxia

The assumptions underlying neuroimaging, and problems in its analysis and interpretation, are commonly underestimated in neuropsychology. The ways in which fluoro-deoxy-glucose (FDG) positron emission tomography (PET) data can be analysed are discussed. PET findings from four patients who had suffered severe amnesia, following episodes of acute hypoxia, are presented. These patients had shown evidence of medial temporal (hippocampal and parahippocampal) atrophy on MRI brain scans. The PET data were analysed in several different ways. The converging findings were that the patients showed bilateral thalamic hypometabolism, and there was also evidence of retrosplenial hypometabolism bilaterally. Cognitively, these patients performed most like other patients with medial temporal lesions, but the results indicate that structural lesions can have distal metabolic effects on structures elsewhere. These findings are interpreted in the light of neuroanatomical observations concerning parallel projections between medial temporal lobe structures and the thalamus, some of which pass via the retrosplenium.     

Do Utility Comparisons Pose a Problem?

Philosophical Studies -     

Tales from the Crypt: On the Role of Death in Life

An existential psychodynamic theory is presented based on Ernest Becker's claim that self-esteem and cultural worldviews function to ameliorate the anxiety associated with the uniquely human awareness of vulnerability and mortality. Psychological equanimity is hypothesized to require (1) a shared set of beliefs about reality that imbues the universe with stability, meaning, and permanence; (2) standards by which individuals can judge themselves to be of value; and (3) promises of safety and the transcendence of death to those who meet the standards of value. An empirical research program in support of this theory is then described, and the personal and interpersonal implications of these ideas are briefly considered.     

Consistent curricular choice and congruence of subsequent changes

Curriculum choices of 324 male and 157 female liberal arts students who took the Strong-Campbell Interest Inventory (SCII) during freshman orientation were classified as congruent or incongruent on the basis of rated correspondence between three-letter codes derived from (SCII) Holland theme scales and expressed curricular choice. The choices of those subjects reporting one or more changes in five semesters were examined for level of congruence using a two-way analysis of variance with repeated measures. While serious methodological limitations are noted, analysis of variance procedures indicated that congruent subjects tended to be more stable, more differentiated, and more academically oriented than incongruent subjects. Among subjects who reported one or more changes, Artistic subjects decreased in congruence while Investigative subjects showed no overall change. Results are discussed in terms of recent theory and previous research.     

Cognitive Slippage in Children Vulnerable to Schizophrenia

Psychological deficit research with adult schizophrenics has been hindered by numerous methodological problems that may be avoided by the prospective study of children vulnerable to the disorder. An object sorting task was administered to 156 children of schizophrenic patients, 102 children of depressed patients, and 139 children of normal parents. The children were between 6 and 15 years old. The children of schizophrenic parents made fewer superordinate sorting responses than those of normal parents, and more complex sorts (a category of inadequate responses) than children of either normal or depressed parents. Our analyses showed that these deficits could not be explained by differences in intelligence. These deficits in conceptual performance may reflect the genotypic predisposition to schizophrenia and/or represent an early precursor of later maladjustment.This research was supported by grant MH 21145 from the National Institutes of Mental Health and by funds from the William T. Grant Foundation. We would like to thank Linda Doll, Diane Liebert, and Jean C. Sullivan for testing the children, and Barbara Mosbacher and Rochelle Weinberger for scoring the protocols.