Dementia with Lewy bodies: a pure case

A pure case of autopsy-confirmed dementia with Lewy bodies (DLB) is described. The patient presented with distinctive verbal fluency deficits in the context of mild language impairment, intact recognition memory, and impaired paragraph recall. Neuroimaging (CT and SPECT) showed progressive medial temporal lobe atrophy. Neuropathology revealed Lewy bodies, degeneration in the substantia nigra, nucleus basalis of Meynert (Nakano & Hirano, 1984), and locus ceruleus, but no pathology characteristic of Alzheimer's disease. It is in this sense that the case is "pure" DLB. Early neuropsychological diagnosis of DLB is essential (Salmon et al., 1996) given the potentially fatal hazard of neuroleptics (McKeith et al., 1992) and the difficulties associated with clinical neurological diagnoses (Litvan et al., 1998).     

Behavioral testing of anxiety: Issues,diagnosis, and practice

This paper cites certain issues of concern in the area of assessment of anxiety and the anxiety disorders. It attempts to describe, in general terms, the potential of behavioral testing for clarifying these issues and for using these tests to supplement clinical interviews, rating scales, and self-report measures. Moreover, the paper describes a potential compatibility between objective behavioral testing and the most recent (third revision)Diagnostic and Statistical Manual of Mental Disorders.The opinions expressed in this paper are those of the author alone and do not necessarily reflect the position of the National Institute of Mental Health.     

Outcomes in a System of Care for Youths with Emotional and Behavioral Disorders: An Examination of Differential Change Across Clinical Profiles

We assessed the utility of an empirically-derived classification system for youths with emotional and behavioral disorders in a system of care with a strong representation of juvenile delinquents. Eighty-seven youths served in a system of care were categorized by variables related to past history, current behavioral functioning, and current psychological functioning into four clinical clusters. We evaluated preliminary clinical outcomes after six months of interagency involvement for youths within each cluster and across the four clusters. Results indicated that youths in different clusters improved significantly in need-specific areas. Trends in our data indicated differential change in clinical outcomes across clusters. We discuss our findings within the context of emerging outcomes of youths involved in comprehensive community-based programs and consider implications for outcome research, treatment of juvenile delinquents, and mental health policy.     

Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.     

Experimental analysis of academic performance in a classroom setting

We evaluated the effects of specific stimulus prompts on accuracy of academic performance with adolescents who displayed academic problems in a public special education classroom. We conducted analyses of instructional strategies within a multielement design with two students who had mild disabilities. Differential effects of the strategies on reading comprehension were not apparent on demand (independent-level) tasks but were apparent on high-demand (instructional-level) tasks. These results suggested that the application of experimental analysis methodologies to instructional variables may facilitate the identification of stimulus prompts associated with accurate academic performance.     

Predictors for relapse and chronicity in eating disorders: A review of follow-up studies

Abstract: Eating disorders have been known to be intractable. Yet, their long-term consequences have received relatively little attention in the literature. In this paper, the outcome and follow-up studies of anorexia nervosa and bulimia are reviewed and the current knowledge of the predictors and correlates of relapse and chronicity in each disorder is summarized. Based on the problems and limitations of the extant studies, suggestions for future research are offered, especially from a developmental perspective, to understand better the mechanisms underlying long-term prognosis and relapse.     

Public and private self-consciousness as specific psychopathological features

Public self-consciousness (PUBSC) and private self-consciousness (PRISC) represent aspects of dispositional self-directed attention. The aim of the present study was to investigate whether four clinical groups, namely patients with a diagnosis of social phobia, panic disorder, obsessive–compulsive disorder or bulimia nervosa, and normal controls differentiated on the basis of their PUBSC and PRISC scores. Results indicated that both PUBSC and PRISC are extremely elevated in patients with social phobia. Patients with panic disorder and patients with obsessive–compulsive disorder score somewhere between social phobics and normal controls on PUBSC and PRISC scales. Bulimics had significantly higher PUBSC values than both controls and patients with panic disorder, but had lower values than social phobics. Compared to normal controls, bulimics showed no elevated PRISC scores. In addition, contrary to the other groups, PUBSC and PRISC seem to be unrelated in bulimics. Thus, PUBSC and PRISC appear to be specific psychopathological features for German females when comparing groups with different mental disorders and normal controls.     

Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions: (1) 3 months before treatment (i.e., baseline), (2) at pretreatment, and (3) at posttreatment. Before and after treatment, scores on traditional childhood anxiety measures (i.e., State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Fear Survey Schedule for Children) were also obtained. Results showed that children's SCARED scores remained relatively stable from baseline to pretreatment. However, from pre- to post-treatment, significant decreases were evident for the SCARED and for all traditional measures. These results suggest that the SCARED reliably taps treatment effects and, thus, provide further support for its utility as a self-report index of childhood anxiety in clinical and research settings.     

A comparison of peer verbal responding directed toward adolescents with behavioral disorders and nonhandicapped peers

One of the primary intents of inclusion is the maximization of interaction between persons with and without disabilities. The purpose of this study was to analyze the verbal responding that peers directed toward adolescents with behavioral disorders and, to this effect, several comparisons were made: verbal responding of peers directed toward adolescents with behavioral disorders was compared to verbal responding of peers directed toward regular class adolescents; verbal responding of peers directed toward the same adolescents with behavioral disorders was compared across their self-contained and integrated settings; and verbal responding of peers directed toward adolescents with behavioral disorders in integrated settings was compared to verbal responding of peers directed toward regular class adolescents. Data, collected in real time using portable microcomputers, focused on positive, negative, and neutral social responding and positive, negative, and neutral academic responding. All verbal responding of peers directed toward 14 adolescents with behavioral disorders and 14 regular class peers was recorded. Data were analyzed by group and setting, as well as by social or academic content. Results of the study support inclusion, with high levels of peer responding directed toward adolescents with behavioral disorders in integrated classrooms. Almost all peer responding was positive or neutral in content. Results were discussed as they related to placement of students, social skills training, and previous research.     

Walter Bradford Cannon: Pioneer of stress research

Walter Bradford Cannon, M.D., made a significant contribution to psychology and medicine with the discovery of the stress response around 1915, setting the cornerstone for psychosomatic medicine. This brief, introductory article etches out the nature of his contribution and sets the stage for Dr. Bradford Cannon to reflect on his father's important professional contributions and personal life in the following article.