Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

The concept of locally specialized functions dominates research on higher brain function and its disorders. Locally specialized functions must be complemented by processes that coordinate those functions, however, and impairment of coordinating processes may be central to some psychotic conditions. Evidence for processes that coordinate activity is provided by neurobiological and psychological studies of contextual disambiguation and dynamic grouping. Mechanisms by which this important class of cognitive functions could be achieved include those long-range connections within and between cortical regions that activate synaptic channels via NMDA-receptors, and which control gain through their voltage-dependent mode of operation. An impairment of these mechanisms is central to PCP-psychosis, and the cognitive capabilities that they could provide are impaired in some forms of schizophrenia. We conclude that impaired cognitive coordination due to reduced ion flow through NMDA-channels is involved in schizophrenia, and we suggest that it may also be involved in other disorders. This perspective suggests several ways in which further research could enhance our understanding of cognitive coordination, its neural basis, and its relevance to psychopathology.     

A four-component model of procedural justice: defining the meaning of a "fair" process

Two studies test the prediction of the four-component model of procedural justice that people evaluate the fairness of group procedures using four distinct types of judgment. The model hypothesizes that people are influenced by two aspects of the formal procedures of the group: those aspects that relate to decision making and those that relate to the quality of treatment that group members are entitled to receive under the rules. In addition, people are hypothesized to be separately influenced by two aspects of the authorities with whom they personally deal: the quality of decision making by those authorities and the quality of the treatment that they receive from them. The results of two studies support the hypothesis of the four-component model by finding that all four of the procedural judgments identified by the model contribute to overall evaluations of the fairness of group procedures.     

Stressor exposure produces long-term reductions in antigen-specific T and B cell responses

Exposure to an acute laboratory stressor at the time of keyhole limpet hemocyanin (KLH) immunization results in a long-term suppression in circulating anti-KLH antibody. The mechanism for the stress-induced reduction in anti-KLH immunoglobulin (Ig) remains unknown. Given that the generation of anti-KLH antibody requires T cell help, we hypothesize that stress reduces the proliferation of anti-KLH T cells, thus leading to a reduction in anti-KLH antibody. The present studies examined the effect of tail shock stress (100, 1.6 mA, 5-s, 60 s ITI) on the KLH specific T cell response. Fischer F344 rats were immunized either intraperitoneally (i.p.) or subcutaneously (s.c.) at the base of the tail with 200 microg KLH, and exposed to inescapable tail shock (IS) or remained in their home cages (HCC). T cell proliferation after KLH restimulation, but not ConA, was markedly suppressed in IS animals in both the spleen after i.p. immunization and the draining lymph nodes after s.c. immunization. Other secondary lymphoid cells did not differ in their proliferative capacity. Anti-KLH IgG, IgG1 and IgG2a, but not anti-KLH IgM serum levels were significantly suppressed. These data support the conclusion that stress suppresses the generation of antigen specific T cells. In addition, the methods employed in the current study allow the isolation of the site of the acquired T cell immune response, making it possible to further elucidate the cellular mechanisms that contribute to stress-induced modulation of the antigen-specific acquired immune response.     

Trauma: the seductive hypothesis

In much of contemporary culture, "trauma" signifies not so much terrible experience as a particular context for understanding and responding to a terrible experience. In therapy, in the media, and in international interventions, the traumatized are seen not simply as people who suffer and so are deserving of concern and aid; they are seen also as people who suffer for us, who are given special dispensation. They are treated with awe if they tell a certain kind of trauma story, and are ignored or vilified if they tell another. Trauma has become not simply a story of pain and its treatment, but a host of sub-stories involving the commodification of altruism, the justification of violence and revenge, the entry point into "true experience," and the place where voyeurism and witnessing intersect. Trauma is today the stuff not only of suffering but of fantasy. Historically, trauma theory and treatment have shown a tension, exemplified in the writings of Freud and Janet, between those who view trauma as formative and those who view it as exceptional. The latter view, that trauma confers exceptional status deserving of special privilege, has gained ground in recent years and has helped to shape the way charitable dollars are distributed, how the traumatized are presented in the media, how governments justify and carry out international responses to trauma, and how therapists attend to their traumatized patients. This response to trauma reflects an underlying, unarticulated belief system derived from narcissism; indeed, trauma has increasingly become the venue, in society and in treatment, where narcissism is permitted to prevail.     

Bimanual cross-talk during reaching movements is primarily related to response selection,not the specification of motor parameters

Simultaneous reaching movements made with the two hands can show a considerable increase in reaction time (RT) when they differ in terms of direction or extent, compared to when the movements involve the same direction and extent. This cost has been attributed to cross-talk in the specification of the motor parameters for the two hands. However, a recent study [Diedrichsen, Hazeltine, Kennerley, & Ivry, (2001). Psychological Science, 12, 493-498] indicates that when reaching movements are cued by the onset of the target endpoint, no compatibility effects are observed. To determine why directly cued movements are immune from interference, we varied the stimulus onset asynchrony for the two movements and used different combinations of directly cued and symbolically cued movements. In two experiments, compatibility effects were only observed when both movements were symbolically cued. No difference was found between compatible and incompatible movements when both movements were directly cued or when one was directly cued and the other was symbolically cued. These results indicate that interference is not related to the specification of movement parameters but instead emerges from processes associated with response selection. Moreover, the data suggest that cross-talk, when present, primarily shortens the RT of the second movement on compatible trials rather than lengthening this RT on incompatible trials.     

Neuropsychopharmacologic treatment of depression and other neuropsychiatric disorders in HIV-infected individuals

How can neuropsychiatric disorders and syndromes be underdiagnosed and inadequately treated in individuals infected with human immunodeficiency virus? Depression in particular is among the most prevalent diagnoses and there is a solid foundation of data from controlled clinical studies that has begun to examine the efficacy of various antidepressants in HIV-infected persons. This article summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of immunodeficiency. This includes discussion of clinically significant treatment considerations (eg, efficacy, side effects, drug-drug interactions) derived from the existing literature. Taken together, there is compelling evidence that psychopharmacologic intervention can improve the quality of life of mentally ill HIV-infected individuals.     

Acquired equivalence and distinctiveness in human discrimination learning: evidence for associative mediation

In the first stage of Experiments 1-3, subjects learned to associate different geometrical figures with colors or with verbal labels. Performance in Stage 2, in which the figures signaled which of 2 motor responses should be performed, was superior in subjects required to make the same response to figures that had shared the same Stage 1 associate. A third stage of testing showed that the events used as associates in Stage 1 were capable of evoking the motor response trained in Stage 2, an outcome predicted by an associative interpretation of such transfer effects. Experiment 4 provided evidence that the relevant associations can be effective in controlling motor responding even when subjects report an antagonistic relationship between events.     

Evaluating NEO Personality Inventory-Revised profiles in veterans with personality disorders

Fifty-one psychiatric, veteran outpatients were assessed for personality disorders on the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997a) and were also administered the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992). Results were compared to Trull and Widiger's (1997) hypotheses about the profiles of such patients and similar past studies. Correlations between NEO-PI-R facets and SCID-II personality disorder symptom clusters generally occurred in the expected direction. Facets hypothesized to be associated with a given personality disorder were able to predict variance in their respective SCID-II personality disorder scores for seven of ten personality disorders. In general, results support the facet-level conceptualizations of these disorders, except for Obsessive-Compulsive Personality Disorder.     

Introduction to the special section on Resources for Enhancing Alzheimer's Caregiver Health (REACH)

This article provides background information and an overview on Resources for Enhancing Alzheimer's Caregiver Health (REACH) a multisite intervention trial for caregivers of persons with Alzheimer's disease designed to reduce caregiver burden and depression. REACH is the largest randomized controlled clinical trial to date, involving 1,222 caregiver and care recipient dyads recruited from 6 different sites in the United States. The authors describe the design of the study, summarize the interventions implemented at each site, and provide an overview of the 4 articles in this special section.     

The Resources for Enhancing Alzheimer's Caregiver Health (REACH): project design and baseline characteristics

The Resources for Enhancing Alzheimer's Cargiver Health (REACH) project was designed to test promising interventions for enhancing family caregiving for persons with dementia. The purpose of this article is to describe the research design, interventions, and outcome measures used in REACH and to characterize the sample recruited for the study. Nine interventions and 2 control conditions were implemented at 6 sites; 1,222 dyads were randomly assigned to an intervention or a control condition. The caregiver sample was 18.6% male with an average age of 62.3 years (56% Caucasian, 24% Black, and 19% Hispanic). Caregivers reported high levels of depressive symptoms and moderate burden. Care recipients were older, with a mean age of 79, and were moderately to severely impaired with mean Mini-Mental State Exam scores of 13/30.