An experiment on measuring awareness of stuttering in individuals with Down syndrome

BackgroundAwareness of stuttering is likely to depend upon the development of the metalinguistic skill to discriminate between fluent speech and stuttering and the ability to identify one’s own speech as fluent or stuttered. Presently, little is known about these abilities in individuals with Down syndrome (DS).PurposeThis study investigates whether individuals with DS and typically developing (TD) children who stutter and who do not stutter differ in their ability to discriminate between fluent speech and stuttering. The second purpose of this study is to discover if this ability is correlated with their self-identification ability.MethodAn experiment to investigate awareness with tasks for discrimination of stuttering and self-identification was developed. It was administered to 28 individuals (7–19 years) with DS, 17 of them stutter and 11 do not, and 20 TD children (3–10 years), 8 of them stutter and 12 do not. Skills to discriminate stuttering were compared between these groups and correlated with self-identification within these groups. The influence of stuttering severity and developmental/chronological age on their ability to discriminate was also investigated.ResultsThe ability to discriminate does not differ significantly between the DS and TD group, but is highly influenced by developmental age. This ability correlates with self-identification but only for the TD individuals who speak fluently.ConclusionThe ability to discriminate matures around the age of 7 and conscious awareness may rely on this ability. Differences between the present findings and earlier studies suggest that differentiation in levels and types of awareness is warranted.     

The role of the cingulate cortex in the generation of motor tics and the experience of the premonitory urge-to-tic in Tourette syndrome

Tourette syndrome (TS) is a neurological disorder of childhood onset that is characterized by the occurrence of motor and vocal tics. TS is associated with cortical-striatal-thalamic-cortical circuit [CSTC] dysfunction and hyper-excitability of cortical limbic and motor regions that are thought to lead to the occurrence of tics. Individuals with TS often report that their tics are preceded by ‘premonitory sensory/urge phenomena’ (PU) that are described as uncomfortable bodily sensations that precede the execution of a tic and are experienced as a strong urge for motor discharge. While the precise role played by PU in the occurrence of tics is largely unknown, they are nonetheless of considerable theoretical and clinical importance as they form a core component of many behavioural therapies used in the treatment of tic disorders. Recent evidence indicates that the cingulate cortex may play an important role in the generation of PU in TS, and in ‘urges-for-action’ more generally. In the current study, we utilized voxel-based morphometry (VBM) techniques, together with ‘seed-to-voxel’ structural covariance network (SCN) mapping, to investigate the putative role played by the cingulate cortex in the generation of motor tics and the experience of PU in a relatively large group of young people with TS. Whole-brain VBM analysis revealed that TS was associated with clusters of significantly reduced grey matter volumes bilaterally within: the orbito-frontal cortex; the cerebellum; and the anterior and mid-cingulate cortex. Similarly, analysis of SCNs associated with bilateral mid- and anterior cingulate ‘seed’ regions demonstrated that TS is associated with increased structural covariance primarily with the bilateral motor cerebellum; the inferior frontal cortex; and the posterior cingulate cortex.     

Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects

Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.     

经前期综合征与奖赏进程失调——来自脑电的证据

研究表明, 经前期综合征(Premenstrual syndromes, PMS)女性的情绪平衡性存在问题, 而现有研究多从负性情绪上升的角度考察PMS的发病机制, 而对其正性情绪缺损的关注不足。鉴于正性情绪与奖赏进程密切相关, 本研究试图从奖赏进程失调的角度考察PMS女性与健康女性的差异以及该差异是否存在阶段特异性的问题, 以期从正性情绪缺损的角度揭示其发病机制。具体而言, 分别选取PMS女性与健康女性23名和22名, 考察两组被试在黄体晚期(即经前期)和卵泡早期(即经后期)正性情绪以及完成赌博任务时的脑电数据时域和频域的差异。主观问卷结果显示, PMS女性的愉快和平静情绪低于健康女性, 并且情绪平衡性也低于健康女性, 但无明显的阶段特异性。时域分析结果显示, PMS组在经前期收到奖赏反馈后奖赏正波(reward positivity, RewP)的波幅和差异波(即奖赏条件和惩罚条件下的差值)的波幅均低于健康女性, 进一步的相关分析结果显示, 对于PMS组来说, 经前期奖赏条件下的RewP波幅和差异波波幅与经前期的情绪平衡性显著正相关。频域分析的结果则发现PMS组在经前期奖赏条件下的θ频段(4~7 Hz, 250~400 ms)能量低于健康组。研究表明, PMS女性在经前期的奖赏加工进程存在异常, 表现为对奖赏反馈的预期增强, 而在收到奖赏反馈后又出现了钝化反应, 且奖赏进程的失调与情绪平衡性相关。本研究为理解PMS女性奖赏进程失调的动态加工时程和神经震荡特征及其与情绪平衡性的关系提供了初步的神经生理证据。     

心理咨询热线在突发性公共卫生事件中的应用分析

2003年SARS在中国一些地区的流行给社会公众在心理上带来了一定程度的影响,在SARS流行期间期间及时开通了面向公众的心理咨询热线,成为了广大公众寻求心理支持的有效途径,为缓解社会压力、促进社会正常秩序恢复起到了积极作用。该文结合中国科学院心理研究所“非典心理咨询热线”的统计数据,进一步探讨了心理咨询热线在应对突发性公共卫生事件中的作用和工作特点。     

Visual attention skills of premature infants with and without intraventricular hemorrhage

The relation between two medical complications associated with prematurity (intraventricular hemorrhage (IVH) and respiratory distress syndrome (RDS)) and visual attention skills of very low birth-weight (VLBW) infants were examined. Fourteen preterm VLBW infants with IVH and RDS, 9 preterms with RDS and no IVH, and 10 full-term infants matched on SES, sex, and race were assessed at 7 months of age (after correction for prematurity) for their ability to show a decremental response to a familiar visual stimulus and an increment in response to a novel visual stimulus. Measures of attention getting (turning toward a stimulus) and attention holding (sustained fixation on the stimulus after turning) were taken. On the attention-getting measures, IVH-RDS preterms had longer latencies than both the RDS-no-IVH preterm group and the full-term group. There were no group differences on attention-holding measures. The three groups did not differ in habituation to the familiar visual stimulus or discrimination of the novel stimulus. This study indicates that the early visual attention skills of preterm infants are differentially affected by specific types of prenatal complications.     

Evidence for a Disturbance of the Body Schema in Neglect

Subjects with left neglect often fail to use and, in some instances, recognize the left side of the body. We performed a series of investigations to determine if this deficit is, at least in part, attributable to an impairment in the “body schema,” an internal three-dimensional, dynamic representation of the spatial and biomechanical properties of one's body. First, subjects were shown a series of pictures of a single hand and asked to determine if the stimulus was a right or left hand. Subjects with neglect but not other subjects with brain lesions identified pictures of left (contralesional) hands significantly less reliably than pictures of right hands. On the basis of evidence demonstrating that the identification of pictured hands involves the matching of the stimuli to an on-line mental representation of one's body, these data suggest that neglect may be associated with a disruption of, or failure to attend to, the body schema. Data from subsequent investigations contrasting patients with left neglect and Gerstmann's syndrome argue for a distinction between a body schema and a “body image,” or conceptual representation of the body which articulates with language.     

Coniunctio—in bodily and psychic modes: dissociation, devitalization and integration in a case of chronic fatigue syndrome

Three years of analytical psychotherapy with a professional woman in mid-life, suffering from chronic fatigue syndrome (CFS), is described. Gradual recovery merged into mid-life changes; marriage, along with a new balance of maternal and paternal imagos, enabled her to trust enough to become pregnant— coniunctio in the most primal bodily and psychic modes.
Her life-long, schizoid type pattern, 'the pendulum of closeness and isolation', with its extreme of psycho-physical collapse and devitalization, was replayed in therapy. The analyst's symbolic attitude is emphasized, containing the patient's initial affective explosion and validating the physicality of her condition. Mirroring and steady rhythmic attunement became a new, pre-verbal, source of trust—vitalization; differentiation and separation replaced defensive splitting and dissociation. Then the overwhelmingly powerful bodily/maternal could be counterbalanced by the masculine, and a transitional space emerged for symbolic work.
Both the regressive and the dynamic aspects of CFS are located in the earliest undifferentiated, archetypal, bodily/psychic modes, when the frustration of primary needs evokes the defences of the self. It is argued that our psychodynamic understanding can contribute to the stalemate in seeing chronic fatigue syndrome as either an organic illness or depression, and that a new linking of the somatic and psychic calls for a new professional collaboration.     

Neurocognitive functioning in chronic fatigue syndrome

Although substantial research has been conducted on chronic fatigue syndrome (CFS) over the past decade, the syndrome remains poorly understood. The most recent case definition describes CFS as being characterized both by disabling fatigue and by subjective reports of difficulty with concentration and short-term memory. However, research into the neurocognitive and psychological functioning of individuals with CFS has provided mixed objective results. The current paper reviews studies that have examined the neurocognitive and/or psychological functioning of individuals with CFS. Changes in research design and instruments employed to study individuals with CFS are suggested.