Growth and social behavior of previously undernourished mice

Developing mice were growth-retarded by underfeeding of their mothers during lactation. Control mothers were well nourished throughout. All offspring were fed ad libitum from weaning till their behaviour was tested in adulthood. The undernourished mice had weight deficits at weaning of 49% compared with controls. Nevertheless, they showed partial catch-up growth thereafter, in that their absolute weight deficits decreased between weaning and adulthood. Social behaviour observations were made on pairs of mice of the same treatment group. Previously undernourished mice were slower to start attacking one another, spent more time near or in contact with one another and did less tail-rattling than their controls.     

Conflict of interest in medicine in Lithuania: legal and ethical aspects

The current legal framework within the Lithuanian health system is described including a review of the physician’s autonomy, rights and duties, and patients’ rights including the right to reimbursement. The role of ethical codes and the law are discussed. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

The little puppet: working with autistic defences in mother-infant psychotherapy

This paper outlines a constellation around birth in our society that is related to advanced western medicine and the way that families move around the globe. It describes a brief therapy with a three-year-old child who was diagnosed as autistic, and a mother who resorted to 'heroic' defences against the anxiety of being unsupported in a strange country. The therapist undertook to process the catastrophic experiences of the birth as expressed in the child's play and transform the accompanying monstrous fantasies into human experiences and thoughts. By providing a maternal container for both mother and child, the therapist was able to dissolve the couple's negative enmeshment and help create a space in the mother's mind in which she could process her own feelings, and thereby process and understand the child's feelings and communications.     

Sustained efficacy of dialectical behaviour therapy for borderline personality disorder

Dialectical Behaviour Therapy (DBT) is considered one of the most promising treatments for borderline personality disorder (BPD). Recently, we reported significantly positive effects of 12 months DBT on parasuicidal behaviour and impulsivity in a mixed group of female BPD patients with and without substance abuse. Fifty-eight women with BPD were randomly assigned to either 52 weeks of DBT or treatment as usual (TAU). Follow-up assessment took place at 78 weeks, i.e., 6 months after discontinuation of DBT. Participants were clinical referrals from addiction treatment and psychiatric services. Outcome measures included parasuicidal behaviour, impulsivity and substance abuse. Six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of parasuicidal and impulsive behaviours, and in alcohol use, sustained. No differences between the treatment conditions were found for drug abuse. In conclusion, DBT seems to have a sustained effect on some of the core symptoms of BPD and on alcohol problems in a mixed population of female borderline patients with and without substance abuse problems.     

Prefrontal brain activity predicts temporally extended decision-making behavior

Although functional neuroimaging studies of human decision-making processes are increasingly common, most of the research in this area has relied on passive tasks that generate little individual variability. Relatively little attention has been paid to the ability of brain activity to predict overt behavior. Using functional magnetic resonance imaging (fMRI), we investigated the neural mechanisms underlying behavior during a dynamic decision task that required subjects to select smaller, short-term monetary payoffs in order to receive larger, long-term gains. The number of trials over which the longterm gains accrued was manipulated experimentally (2 versus 12). Event-related neural activity in right lateral prefrontal cortex, a region associated with high-level cognitive processing, selectively predicted choice behavior in both conditions, whereas insular cortex responded to fluctuations in amount of reward but did not predict choice behavior. These results demonstrate the utility of a functional neuroimaging approach in behavioral psychology, showing that (a) highly circumscribed brain regions are capable of predicting complex choice behavior, and (b) fMRI has the ability to dissociate the contributions of different neural mechanisms to particular behavioral tasks.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Hostility and facial affect recognition: effects of a cold pressor stressor on accuracy and cardiovascular reactivity

The effects of hostility and a cold pressor stressor on the accuracy of facial affect perception were examined in the present experiment. A mechanism whereby physiological arousal level is mediated by systems which also mediate accuracy of an individual’s interpretation of affective cues is described. Right-handed participants were classified as high hostile (N=28) or low hostile (N=28) using the Cook Medley Hostility Scale. The high-hostile group met joint selection criteria. Only high-hostile participants who showed cardiovascular reactivity to the cold pressor, with systolic BP change exceeding the group mean were included. Groups were further subdivided into cold pressor and non-cold pressor test conditions. It was predicted that high-hostile men, relative to low-hostile men, would show decreased perceptual accuracy when presented with happy, angry, and neutral facial configurations within the left visual field (LVF). Results indicated that high-hostile men were less accurate than low-hostile men in the LVF. Further, pre-stress accuracy scores in the high-hostile men were similar to the post-stress accuracy scores of the low-hostile men. The lateralization of affective function and the role of physiological arousal in affective facial perception are discussed.     

The relationship between disgust sensitivity, anxiety and obsessions

Three hundred participants, including volunteers from an obsessional support group, filled in questionnaires relating to disgust sensitivity, health anxiety, anxiety, fear of death, fear of contamination and obsessionality as part of an investigation into the involvement of disgust sensitivity in types of obsessions. Overall, the data supported the hypothesis that a relationship does exist between disgust sensitivity and the targeted variables. A significant predictive relationship was found between disgust sensitivity and total scores on the obsessive compulsive inventory (OCI; Psychological Assessment 10 (1998) 206) for both frequency and distress of symptomatology. Disgust sensitivity scores were significantly related to health anxiety scores and general anxiety scores and to all the obsessional subscales, with the exception of hoarding. Additionally, multiple regression analyses revealed that disgust sensitivity may be more specifically related to washing compulsions: frequency of washing behaviour was best predicted by disgust sensitivity scores. Washing distress scores were best predicted by health anxiety scores, though disgust sensitivity entered in the second model. It is suggested that further research on the relationship between disgust sensitivity and obsessionality could be helpful in refining the theoretical understanding of obsessions.     

Cognitive behaviour therapy of acute stress disorder: a four-year follow-up

The aim of this study was to index the long-term benefits of early provision of cognitive behavior therapy to trauma survivors with acute stress disorder. Civilian trauma survivors (n = 80) with acute stress disorder were randomly allocated to either cognitive behavior therapy (CBT) or supportive counseling (SC) - 69 completed treatment, and 41 were assessed four years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician Administered PTSD Scale. Two CBT patients (8%) and four SC patients (25%) met PTSD criteria at four-year follow-up. Patients who received CBT reported less intense PTSD symptoms, and particularly less frequent and less avoidance symptoms, than patients who received SC. These findings suggest that early provision of CBT in the initial month after trauma has long-term benefits for people who are at risk of developing PTSD.