Identifying environmental contributions to autism: provocative clues and false leads

The potential role of environmental factors in autism spectrum disorders (ASD) is an area of emerging interest within the public and scientific communities. The high degree of heritability of ASD suggests that environmental influences are likely to operate through their interaction with genetic susceptibility during vulnerable periods of development. Evaluation of the plausibility of specific neurotoxicants as etiological agents in ASD should be guided by toxicological principles, including dose-effect dependency and pharmacokinetic parameters. Clinical and epidemiological investigations require the use of sufficiently powered study designs with appropriate control groups and unbiased case ascertainment and exposure assessment. Although much of the existing data that have been used to implicate environmental agents in ASD are limited by methodological shortcomings, a number of efforts are underway that will allow more rigorous evaluation of the role of environmental exposures in the etiology and/or phenotypic expression of the disorder. Surveillance systems are now in place that will provide reliable prevalence estimates going forward in time. Anticipated discoveries in genetics, brain pathology, and the molecular/cellular basis of functional impairment in ASD are likely to provide new opportunities to explore environmental aspects of this disorder.     

Placebo and criminal law

This article considers issues concerning cases where the use of placebo is lawful or is not lawful under aspects of German criminal law. It will differentiate between cases of individual therapy and cases of supervised experiments within the scope of medical tests. Thereby, it reveals that a medication of placebo with regard to an individual patient seems to be lawful if there is no alternative possibility of a better treatment using a chemically effective medicine and if the limits of presumed consent are complied with. On the other hand, in the context of the supervised experiment, the assignment of a patient to a group treated with placebo is only lawful if the patient has been fully informed about the possibilities of a treatment and if the patient has given consent to it. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003. The author’s interests include International Criminal Law, Comparative Criminal Law and Philosophy of Law.     

Unimodal and crossmodal effects of endogenous attention to visual and auditory motion

Three experiments were conducted examining unimodal and crossmodal effects of attention to motion. Horizontally moving sounds and dot patterns were presented and participants’ task was to discriminate their motion speed or whether they were presented with a brief gap. In Experiments 1 and 2, stimuli of one modality and of one direction were presented with a higher probability ( p = .7) than other stimuli. Sounds and dot patterns moving in the expected direction were discriminated faster than stimuli moving in the unexpected direction. In Experiment 3, participants had to respond only to stimuli moving in one direction within the primary modality, but to all stimuli regardless of their direction within the rarer secondary modality. Stimuli of the secondary modality moving in the attended direction were discriminated faster than were oppositely moving stimuli. Results suggest that attending to the direction of motion affects perception within vision and audition, but also across modalities.     

Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control

The present study investigated the relative extent to which patients' adjustment to chronic low back pain (CLBP) was influenced by their fear-avoidance beliefs, their tendency to catastrophize, and their appraisals of control. Eighty-three CLBP patients completed a series of self-report measures before participating in a physical therapist-led intervention. Hierarchical multiple regression analyses revealed that patients' perceptions of their ability to decrease pain explained a small, but statistically significant, proportion of the variance in pain intensity. In addition, patients' levels of catastrophizing, as well as their fear-avoidance beliefs about both work and physical activity, were independently associated with levels of disability. Interestingly, however, when exploring the relative predictive utility of these three psychological factors, it became evident that fear-avoidance beliefs about physical activity (FABs-PA) were the only significant predictor of patients' disability. Specifically, those patients who exhibited higher levels of FABs-PA tended to report greater levels of disability, even after adjusting for age, sex and pain intensity.     

A multiple-goal, multilevel model of feedback effects on the regulation of individual and team performance

When working as a member of a team, individuals must make decisions concerning the allocation of resources (e.g., effort) toward individual goals and team goals. As a result, individual and team goals, and feedback related to progress toward these goals, should be potent levers for affecting resource allocation decisions. This research develops a multilevel, multiple-goal model of individual and team regulatory processes that affect the allocation of resources across individual and team goals resulting in individual and team performance. On the basis of this model, predictions concerning the impact of individual and team performance feedback are examined empirically to evaluate the model and to understand the influence of feedback on regulatory processes and resource allocation. Two hundred thirty-seven participants were randomly formed into 79 teams of 3 that performed a simulated radar task that required teamwork. Results support the model and the predicted role of feedback in affecting the allocation of resources when individuals strive to accomplish both individual and team goals.     

Religiosity, values, and horizontal and vertical individualism-collectivism: a study of Turkey, the United States, and the Philippines

The authors examined the links between two dimensions that have been useful in understanding cross-cultural differences and similarities, namely, individualism-collectivism (I-C) and value orientations. The authors examined the relations and parallels between the two variables by directly relating them and examining the patterns of relations that both have with a third variable, religiosity. Participants were 475 college students from the Philippines, the United States, and Turkey who responded to measures of horizontal and vertical I-C, value orientations, and religiosity. The authors found partial support for the parallels between I-C and value types, particularly for collectivism and conservative values. Moreover, religiosity was associated positively with conservative values and collectivism, across all three cultures. The authors found individualism to also relate to openness-to-change values, though the patterns were not as consistent as those that they found between collectivism and conservation. Differences and similarities emerged in links of I-C-values to religiosity across the three samples.     

The US-preexposure effect in lithium-induced flavor-aversion conditioning is a consequence of blocking by injection cues

In 2 experiments, rats received flavor-aversion conditioning in which the unconditioned stimulus (US) was an orally consumed solution of lithium chloride (LiCl). The resulting aversion was not attenuated by giving preexposure to injections of LiCl, although such preexposure did attenuate aversions established using injected LiCl as the US (Experiment 1). This outcome suggests that blocking by injection-related cues is responsible for the US-preexposure effect observed in this situation. Experiment 2 confirmed this interpretation by showing that presenting such cues (by giving an injection of saline) at the time that the LiCl was drunk resulted in an attenuation of conditioning in animals preexposed to injections of LiCl. The US-preexposure effect obtained in these experiments can be explained solely in terms of blocking by injection cues, although other mechanisms may contribute to the effect seen in other flavor-aversion paradigms.     

Unglücklich machende Familienideale

Zusammenfassung Der Artikel konstrastiert familiäre Lebensrealitäten und familiäre Idealvorstellungen miteinander. Für Patienten, bei denen beide weit auseinander klaffen, werden Anregungen für die Dekonstruktion selbstquälerischer Familienideale in der Psychotherapie entwickelt. Als potenziell unglücklich machend werden Familienideale beschrieben, nach denen Kinder (nur) eine Familie und Familien (nur) ein Heim brauchen; dass Familien gemeinsam verbrachte Zeit, Söhne ihre Väter und überhaupt Kinder heterosexuelle Eltern bräuchten; dass Eltern einander lieben und ihre Kinder bei sich behalten sollten; dass Kinder sich von ihren Eltern ablösen sollten. Als psychotherapeutisch nützlich werden aus Familiensoziologie und systemischer Psychotherapie die Ideen der Wahlverwandtschaft, der konsensentlasteten Diskurse und der systemischen Selbstbeobachtung empfohlen, ferner als therapeutische Techniken die zirkulären Fragen, speziell Verschlimmerungsfragen und die positive Umdeutung. Die Konstruktion neuer Rituale und die Nutzung von Netzwerkressourcen stehen am Ende der Untersuchung.Überarbeitete Fassung des Eröffnungsvortrags der Lübecker Psychotherapiewoche, 17.10.1999.     

DRG-Vergütung und Kosten stationärer integrierter psychosomatischer Behandlung

Ohne ZusammenfassungDie Autoren M. Rose und R. Lohmann zeichnen für den Beitrag als gleichberechtigte Erstautoren.