Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study

With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.     

Development and validation of the Shy Bladder and Bowel Scale (SBBS)

Currently research exploring paruresis and parcopresis, anxiety relating to urinating and having bowel motions in public respectively is limited. While there are several validated measures of paruresis, no valid measure assessing parcopresis is currently available. The present study investigates the development and validation of the Shy Bladder and Bowel Scale (SBBS) which assesses both paruresis and parcopresis. Two participant groups were utilised to validate this scale, a student psychology cohort (n = 387) and a public cohort (n = 334). An eight-item two-factor model was identified in the psychology cohort and confirmed in the public cohort. The two-factor SBBS was found to be a valid and reliable measure of paruresis and parcopresis. Paruresis and parcopresis-related concerns were associated with social anxiety in both cohorts. Subscales for both paruresis and parcopresis (i.e. difficulty, interference and distress) were positively correlated, suggesting individuals are likely to report similar levels of concerns across both conditions. Further, individuals self-identifying with either paruresis or parcopresis reported significantly higher scores on the respective SBBS subscales than non-identifying paruresis and parcopresis individuals. The SBBS also demonstrated strong test–retest reliability in a small sample of adults (n = 13). Overall, the developed scale provides clinicians and researchers with a valuable tool to evaluate both paruresis and parcopresis.     

The effects of co‐occurring ADHD symptoms on electrophysiological correlates of cognitive control in young people with Tourette syndrome

Efficient cognitive control is implicated in tic control in young people with Tourette syndrome (TS). Attention‐deficit/hyperactivity disorder (ADHD) frequently co‐occurs with TS and is associated with impaired cognitive control. Young people with TS and ADHD (TS+ADHD) show poorer cognitive control performance than those with TS, but how co‐occurring ADHD affects underlying neural activity is unknown. We investigated this issue by examining behavioural and event‐related potential (ERP) correlates of cognitive control in young people with these conditions. Participants aged 9–17 with TS (n = 17), TS+ADHD (n = 17), ADHD (n = 11), and unaffected controls (n = 20) performed a visual Go/Nogo task during electroencephalography (EEG) recording. Behavioural performance measures (D‐prime, RT, reaction time variability, post‐error slowing) and ERP measures (N2, P3, error‐related negativity (ERN), error positivity (Pe)) were analysed in a 2 (TS‐yes, TS‐no) × 2 (ADHD‐yes, ADHD‐no) factorial analysis to investigate the effects of TS, ADHD, and their interaction. The results of these analyses showed that ADHD was associated with poorer performance and reduced amplitude of all ERPs, reflecting widespread cognitive control impairments. Tourette syndrome was associated with slowed RTs, which might reflect a compensatory slowing of motor output to facilitate tic control. There was no interaction between the TS and ADHD factors for any behavioural or ERP measure, indicating the impairing effects of ADHD on behaviour and electrophysiological markers of cognitive control were present in TS+ADHD and that RT slowing associated with TS was unaffected by co‐occurring ADHD symptoms.     

Route learning in Korsakoff's syndrome: Residual acquisition of spatial memory despite profound amnesia

Korsakoff's syndrome (KS) is characterized by explicit amnesia, but relatively spared implicit memory. The aim of this study was to assess to what extent KS patients can acquire spatial information while performing a spatial navigation task. Furthermore, we examined whether residual spatial acquisition in KS was based on automatic or effortful coding processes. Therefore, 20 KS patients and 20 matched healthy controls performed six tasks on spatial navigation after they navigated through a residential area. Ten participants per group were instructed to pay close attention (intentional condition), while 10 received mock instructions (incidental condition). KS patients showed hampered performance on a majority of tasks, yet their performance was superior to chance level on a route time and distance estimation tasks, a map drawing task and a route walking task. Performance was relatively spared on the route distance estimation task, but there were large variations between participants. Acquisition in KS was automatic rather than effortful, since no significant differences were obtained between the intentional and incidental condition on any task, whereas for the healthy controls, the intention to learn was beneficial for the map drawing task and the route walking task. The results of this study suggest that KS patients are still able to acquire spatial information during navigation on multiple domains despite the presence of the explicit amnesia. Residual acquisition is most likely based on automatic coding processes.     

Genetic Counseling for Fragile X Syndrome: Recommendations of the National Society of Genetic Counselors

The National Society of Genetic Counselors' (NSGC) recommendations for fragile X syndrome (FXS) genetic counseling are intended to assist health care professionals who provide genetic counseling for individuals and families in whom the diagnosis of FXS is strongly suspected or has been made. The recommendations are the opinions of genetic counselors with expertise in FXS counseling and are based on clinical experience, a review of pertinent English language medical articles, and reports of expert committees. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a particular client.     

In the Search for a Post-Communist Syndrome: A Theoretical Framework and Empirical Assessment

A pattern of attitudes and behaviours in the recently freed, post-communist countries is hypothesized as a post-communist syndrome. This study describes the syndrome and its aetiology. The syndrome is viewed as a direct result of long-lasting, oppressive rule and suggests a host of individual and social disorders: learned helplessness, specific manifestations of immorality/incivility, lack of civic culture and civic virtues. Using Q-factor analysis of ‘civic culture’ in a sample of Czech, Hungarian and American students it was found that contrary to the hypothesis, the Czech respondents exhibited a robust civic culture. (© 1997 by John Wiley & Sons, Ltd.)     

Implicit sequence learning in young people with Tourette syndrome with and without co-occurring attention-deficit/hyperactivity disorder

Impaired habit-learning has been proposed to underlie the tic symptoms of Tourette syndrome (TS). However, accounts differ in terms of how habit-learning is altered in TS, with some authors proposing habit formation is impaired due to a deficient ‘chunking’ mechanism, and others proposing habit-learning is overactive and tics reflect hyperlearned behaviours. Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with TS and is known to affect cognitive function in young people with co-occurring TS and ADHD (TS + ADHD). It is unclear, however, how co-occurring ADHD symptoms affect habit-learning in TS. In this study, we investigated whether young people with TS would show deficient or hyperactive habit-learning, and assessed the effects of co-occurring ADHD symptoms on habit-learning in TS. Participants aged 9–17 years with TS (n = 18), TS + ADHD (n = 17), ADHD (n = 13), and typical development (n = 20) completed a motor sequence learning task to assess habit-learning. We used a 2 (TS-yes, TS-no) × 2 (ADHD-yes, ADHD-no) factorial analysis to test the effects of TS, ADHD, and their interaction on accuracy and reaction time indices of sequence learning. TS was associated with intact sequence learning, but a tendency for difficulty transitioning from sequenced to non-sequenced performance was suggestive of hyper-learning. ADHD was associated with significantly poorer accuracy during acquisition of the sequence, indicative of impaired habit-learning. There were no interactions between the TS and ADHD factors, indicating young people with TS + ADHD showed both TS- and ADHD-related atypicalities in habit-learning.     

Preserved re-experience of discrete emotions: Amnesia and executive function

Amnesic patients can re-experience emotions elicited by forgotten events, suggesting that brain systems for episodic and emotional memory are independent. However, the range of such emotional memories remains under-investigated (most studies employing just positive–negative emotion dyads), and executive function may also play a role in the re-experience of emotions. This is the first investigation of the intensity of the emotional re-experience of a range of discrete emotions (anger, fear, sadness, and happiness) for a group of amnesic patients. Twenty Korsakoff syndrome (KS) patients and 20 neurologically normal controls listened to four novel emotional vignettes selectively eliciting the four basic emotions. Emotional experience was measured using pen-and-paper Visual Analogue Mood Scales and episodic memory using verbal recollections. After 30 min, the recollection of stories was severely impaired for the patient group, but the emotional re-experience was no different from that of controls. Notably, there was no relationship between episodic recall and the intensity of the four emotions, such that even profoundly amnesic patients reported moderate levels of the target emotion. Exploratory analyses revealed negative correlations between the intensity of basic emotions and executive functions (e.g., cognitive flexibility and response inhibition) for controls but not patients. The results suggest that discrete emotions can be re-experienced independently of episodic memory, and that the re-experience of certain discrete emotions appears to be dampened by executive control. KS patients with absent or mild cognitive symptoms should benefit from emotion-regulation interventions aimed at reducing the recognized affective burden associated with their episodic memory deficit.