A poor metabolizer for cytochromes P450 2D6 and 2C19: a case report on antidepressant treatment

Scientific literature has never described a poor metabolizer for both the cytochrome P450 (CYP) 2D6 and the CYP 2C19. They are expected to be rare (<1% in different ethnic groups) and prone to adverse drug reactions with many antidepressants. In an ongoing pharmacogenetic study, after genotyping 1,576 subjects in three Kentucky state hospitals we have found one poor metabolizer for both CYP 2D6 and CYP 2C19, which corresponds to a prevalence of 0.06% (95% CI 0.01 to 0.36). The naturalistic antidepressant treatment of this poor metabolizer for both enzymes is described in this article. As genotyping reaches clinical practice, it will be interesting to prospectively establish whether mirtazapine is a reasonable choice as an antidepressant for these patients, as the data and this case suggest.     

Culture and Personal Epistemology: U.S. and Middle Eastern Students’ beliefs about Scientific Knowledge and Knowing

Middle Eastern (Omani) and Western (U.S.) students’ beliefs about knowledge and knowing in the sciences were compared on four dimensions of personal epistemology proposed by Hofer and Pintrich (Review of Educational Research (1997), 67, 88–140). As predicted, given their experiences with comparatively traditional political and religious institutions, Omani more so than U.S. college students were more likely to accept scientific authorities as the basis of scientific truth. Furthermore, Omani men were more accepting of authorities than were Omani women, but there was no gender difference among U.S. students. Omani more than U.S. students also believed that knowledge in the sciences was simpler and more certain, which is consistent with comparisons between U.S. and Asian students (e.g., Qian & Pan, 2002, A comparision of epistemological beliefs and learning from science text between American and Chinese high school students. In B. K. Hofer & P. R. Pintrich (Eds.), Personal epistomology: The psychology of beliefs about knowledge and knowing (pp. 365–385), Mahwah, NJ: Erlbaum). Students in the two countries did not differ, however, in whether their beliefs were based on personal opinions versus systematic evidence. Suggestions for further research included directly assessing experiences with, and attitudes toward, authorities in academic and other areas of students’ lives.     

Impressions of people with gender-ambiguous male or female first names

Undergraduates (12 men, 12 women) read a scenario in which they formed an impression of nine people who had left their first name on an answering machine. Participants rated the extent to which seven characteristics (Ethical, Caring, Popular, Cheerful, Successful, Masculine, Feminine) applied to people whose first names were gender-ambiguous (e.g., Chris), male (e.g., Ken) or female (e.g., Pam). People with gender-ambiguous names were rated less Ethical than those with female names, and people with gender-ambiguous names and male names were rated less Caring, less Cheerful, and less Feminine than those with female names. These results are consistent with the idea that there is a bias towards assuming that a person of unspecified sex is a male.     

Assessing adolescents who threaten homicide in schools

Psychoanalytic and psychiatric perspectives on children who threaten to kill others are reviewed in the context of the need for an interdisciplinary approach to the problem. Converging technologies derived from a psychoanalytically informed social systems model are compared to law enforcement approaches, psychoanalytic understanding of the individual dynamics of the child, and empirical research on conduct disordered adolescents. The interdisciplinary orientation of a broadly trained community psychoanalyst allows a unique contribution when trying to distinguish adolescents who make a threat from those who pose a threat. Case vignettes are used to illustrate the hypotheses.     

The role of attack and defense semantics in skilled players’ memory for chess positions

There is much evidence that chess skill is based on chunks in memory that represent parts of positions from previously encountered games. However, the content of these chunks is a matter for debate. According to one view, (1) the closer two pieces are to each other on a board (proximity), the more likely they are to be in the same chunk, and (2) skilled players encode the precise locations of pieces. An alternative view is that what information is encoded in a chess chunk is determined more by processing of the attack/defense relations during evaluation. In three experiments, participants evaluated positions and completed recognition tests. Experiment 1 supported the view that expert players make more use of attack/defense relations than of locations of pieces in a recognition test. Experiments 2 and 3 demonstrated that, for both long and short presentation times, expert players' recognition for a piece within a position was primed more by a piece related by attack or defense than by a piece merely proximal. These findings challenge theories of expertise for chess that assume a primary role for proximity and location in determining which pieces are grouped together in memory.     

The emergence of a new paradigm in ape language research

In recent years we have seen a dramatic shift, in several different areas of communication studies, from an information-theoretic to a dynamic systems paradigm. In an information processing system, communication, whether between cells, mammals, apes, or humans, is said to occur when one organism encodes information into a signal that is transmitted to another organism that decodes the signal. In a dynamic system, all of the elements are continuously interacting with and changing in respect to one another, and an aggregate pattern emerges from this mutual co-action. Whereas the information-processing paradigm looks at communication as a linear, binary sequence of events, the dynamic systems paradigm looks at the relation between behaviors and how the whole configuration changes over time. One of the most dramatic examples of the significance of shifting from an information processing to a dynamic systems paradigm can be found in the debate over the interpretation of recent advances in ape language research (ALR). To some extent, many of the early ALR studies reinforced the stereotype that animal communication is functional and stimulus bound, precisely because they were based on an information-processing paradigm that promoted a static model of communicative development. But Savage-Rumbaugh's recent results with bonobos has introduced an entirely new dimension into this debate. Shifting the terms of the discussion from an information-processing to a dynamic systems paradigm not only highlights the striking differences between Savage-Rumbaugh's research and earlier ALR studies, but further, it sheds illuminating light on the factors that underpin the development of communication skills in great apes and humans, and the relationship between communicative development and the development of language.     

Serious delinquent behavior,sensation seeking,and electrodermal arousal

Low tonic skin conductance level (SCL) has been related, inconsistently, to both delinquency and sensation-seeking. This study tests the hypothesis that there is an interaction such that high sensation seeking delinquents, in particular, have low SCLs. Participants consisted of 335 boys from the Pittsburgh Youth Study classified as serious delinquents or controls based upon 10 years of prospectively collected self-report delinquency data. Participants' skin conductance was evaluated at age 16 along with several personality and neuropsychological measures. Both delinquency and sensation seeking were characterized by low SCL. However, there was no evidence to suggest that the presence of both of these factors together lead to especially low skin conductance levels. This finding is not explained by differences between the groups on measures of negative emotionality, IQ, socioeconomic status, or impulsivity.     

The defense of extreme emotional disturbance in New York County: pleas and outcomes

A number of studies have investigated the use of the insanity defense; however, there are few reports on the use of other types of psychiatric defenses. This study explored the use of the affirmative psychiatric defense of extreme emotional disturbance (EED) in New York County (one of the five counties which comprise New York City). The results of the study indicate that, as in the case of the insanity defense, EED is rarely proffered by criminal defendants (plea rate 0.84%). The defense only prevailed on one occasion at a jury trial. While the EED defense was successful 39% of the time that it was entered, this was usually only when the prosecutor accepted the argument that was offered by the defense.     

Client perceptions of hindering experiences in counselling

The purpose of this study was to increase understanding of what clients perceive as hindering experiences in counselling. In‐depth interviews combined with concept mapping were used to gather, organize, and understand clients' perceptions of hindering aspects of therapy. In the initial data gathering stage, 8 adult client participants, aged 18 or older (average of 14.1 sessions) were asked to respond to the following open‐ended questions:

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The Penn Psychoanalytic Treatment Collection: a set of complete and recorded psychoanalyses as a research resource

From a set of seventeen complete and tape-recorded psychoanalyses, a sample of findings is presented: (a) the level of agreement of two clinical judges on the psychological health of these patients is adequate for the late sessions, but not for the early sessions; (b) the amount of change during psychoanalysis appears to be similar to that in the Menninger Foundation Psychotherapy Research Project; (c) psychiatric severity measures from the early sessions can yield a significant level of prediction of the later benefits from psychoanalysis. Finally, further research uses of this collection of psychoanalyses are suggested.