Treatment of Diogenes Syndrome with Risperidone

Diogenes syndrome is characterized by shameless neglect of the body and personal environment, hoarding, and the rejection of any help. It occurs among patients with and without other psychiatric disorders. The initial treatment should be a behavioral program, but there is no information about the pharmacological treatment of this syndrome. We report the case of a 77-year-old woman with symptoms of Diogenes syndrome. After an unsuccessful behavioral program, treatment with risperidone initially improved the behavioral symptoms but impaired cognitive function, and was followed by marked global deterioration, fulfilling criteria for dementia.     

Priming and interference effects can be dissociated in the Stroop task: new evidence in favor of the automaticity of word recognition

Recently, Besner, Stolz, and Boutilier (1997) showed that by coloring a single letter instead of the whole word, Stroop interference is reduced or even eliminated, a result that is at odds with the widely accepted assumption that word recognition is automatic. In a replication of the Besner et al. study, we computed priming effects in addition to the standard Stroop interference. Interference results replicated those of Besner et al. Also, negative priming in the all-letter-colored condition and positive priming in the single-letter-colored condition were obtained. Priming findings demonstrate that word processing can take place in the absence of interference effects. These results support the view of automatic processing of words in the Stroop task and call for priming as a more appropriate measure of word processing than interference.     

A single exposure to severe stressors causes long-term desensitisation of the physiological response to the homotypic stressor

Although some laboratories have reported that a single session of stress is able to induce a long-lasting sensitisation of the hypothalamic-pituitary-adrenal (HPA) response to further exposures to stress, we have found that a single exposure to severe emotional (immobilisation, restraint or shock) or systemic (endotoxin) stressors reduces the responsiveness of the HPA to the same, but not to a novel (heterotypic), stressor, in which case a slight sensitisation was observed. Long-term desensitisation has been found to reduce not only secretion of peripheral HPA hormones (ACTH and corticosterone), but also to reduce responses of central components of the HPA axis (c-fos and CRF gene expression at the level of the paraventricular nucleus of the hypothalamus, PVN). In addition, desensitisation also applies to the impact of the stressor on food intake and, probably, to stress-induced hyperglycaemia. The development of long-term desensitisation of the HPA axis does not appear to be a universal consequence of exposure to severe stressors as it was not observed in response to insulin-induced hypoglycaemia. Whether or not the development of long-term effects of stress depend on the specific pathways activated by particular stressors remains to be tested. The observed desensitisation of the HPA axis in response to the homotypic stressor shows two special features which makes it difficult to be interpreted in terms of an habituation-like process: (a) the effect increased with time (days to weeks) elapsed between the first and second exposure to the stressor, suggesting a progressive maturational process; and (b) the stronger the stressor the greater the long-term desensitisation. Therefore, it is possible that desensitisation of the HPA axis is the sum of two different phenomena: long-term effects and habituation-like processes. The contribution of the former may be more relevant with severe stressors and longer inter-stress intervals, and that of the latter with mild stressors and repeated exposures. Long-term stress-induced changes may not take place at the level of the PVN itself, but in brain nuclei showing synaptic plasticity and putatively involved in the control of the HPA axis and other physiological responses. As for the precise areas involved, these remain to be characterized.     

A note on Skinner and Pavlov's physiology

These short notes describe the way in which Skinner considers and resolves his differences with Pavlov in the question of the relation between psychology and physiology as forms of knowledge. After establishing his viewpoint in the general epistemological issue, Skinner is concerned about linking his study of behavior to the work of Pavlov, who considered it to be of a physiological nature. Skinner contrasts Pavlov's empirical and theoretical work and characterizes the latter in terms of the notion of the "Conceptual Nervous System."     

Women and vulnerability to depression: some personality and clinical factors

The purpose of this study is to explore the role of sex differences and personality in vulnerability to depression. Sex differences in personality and some clinical variables are described. We also assess the value of the variables that revealed significant sex differences as predictors of vulnerability to depression. In a group of adult participants (N = 112), 50% males and 50% females (mean age = 41.30; SD = 15.09; range 17-67), we studied sex differences in the three-factor personality model, using the Eysenck Personality Questionnaire, Form A (EPQ-A; Eysenck & Eysenck, 1975), and in the Five-Factor Personality Model, with the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985). The following clinical scales were used: the Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979), the Schizotypy Questionnaire (STQ; Claridge & Broks, 1984; Spanish version, Carrillo & Rojo, 1999), the THARL Scales (Dua, 1989, 1990; Spanish version, Dua & Carrillo, 1994) and the Adjustment Inventory (Bell, 1937; Spanish version, Cerdá, 1980). Subsequently, simple linear regression analysis, with BDI scores as criterion, were performed to estimate the value of the variables as predictors of vulnerability to depression. The results indicate that a series of personality variables cause women to be more vulnerable to depression than men and that these variables could be explained by a negative emotion main factor. Results are discussed within the framework of the psychological behaviorism theory of depression.     

Influence of metacognitive variables and thought suppression on number of thoughts, discomfort they produce and number and quality of auditory illusions

Based on the model proposed by Morrison, Haddock & Tarrier (1995) on auditory hallucinations, this study explores the relationships between certain metacognitive variables and number of thoughts, the discomfort they produce, number of auditory illusions and the quality with which they are perceived in a sample from a non-clinical population. After group administration of the Metacognitions Questionnaire, 61 participants were randomly assigned to a suppression group (n = 31) or a focalization group (n = 30) in relation to thoughts with different degrees of self-discrepancy. Forty-eight hours after the set task, a non-vocal auditory stimulus was presented, and subjects were required to say whether they heard any words and, if so, how clearly. The results show how the metacognitive factors studied are useful for predicting our findings only for the suppression group and not for that of focalization. These data are discussed in the light of Morrison et al.'s model of auditory hallucinations.     

Intrauterine infection and prematurity

Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation.     

Context change as the mechanism of reinstatement in causal learning

Four experiments were conducted to explore the mechanism of reinstatement in human causal learning. After a retroactive interference treatment in which a stimulus was first followed by an outcome (A+) and then followed by a different outcome (A*), simple exposure to the original outcome (+) in the interference-test context produced partial reinstatement of the first-learned information (A+). When exposure to the outcome took place in a context different from the interference-test context, reinstatement was not observed (Experiment 1). Equivalent results appeared when the outcome presented during reinstatement was different from the one originally related to the stimulus affected by interference, independent of whether the interfering outcome (Experiments 2, 3, and 4) or a new outcome (Experiments 3 and 4) was presented before the test. These results suggest an interpretation of reinstatement in terms of a context change between interference and testing.     

Paradoxes in the Argumentation of the Comic Double and Classemic Contradiction

In the comedies of errors, and more precisely in the comedies of double, in which two identities become confused, the characters get into paradoxical situations reigned by the principle of contradiction. The classemic relationships that are based on the criterion of subjectivity are broken due to the intervention of the character appearing as the double, for the doubled and the double can appear as one subject or as two. In fact, in the added double one + one equals one (1 + 1 = 1; Sosia + Mercury = Sosia) and in the split double one equals one + one (1 = 1 + 1; Philocomasium = Philocomasium + Dicea). In the modal oppositions of the alternative class (present absent, to be not to be) and in the aspectual oppositions of the sequential class (to arrive – to be in) the intrasubjective nature is cancelled; in the diathetic or complementary oppositions (to give .– to receive) the intersubjective relationship gets broken. Thus, it turns out that, due to the action of the double, a character can be present and absent at the same time, be and not be the same, be in a place before arriving there or have received what another has not yet given him.